Provider Demographics
NPI:1366841058
Name:COHEN, NAIKE (DPT)
Entity Type:Individual
Prefix:
First Name:NAIKE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24630 WASHINGTON AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6131
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:255 N ELM ST
Practice Address - Street 2:STE. 202
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3431
Practice Address - Country:US
Practice Address - Phone:760-504-0223
Practice Address - Fax:760-504-0224
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB131123Medicare PIN
CACB220694Medicare PIN
CACB131121Medicare PIN
CACB131122Medicare PIN
CACB220693Medicare PIN