Provider Demographics
NPI:1386857605
Name:ESTRIN, DOREEN B (PT)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:B
Last Name:ESTRIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 LOMA RIVIERA LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5517
Mailing Address - Country:US
Mailing Address - Phone:619-225-8575
Mailing Address - Fax:
Practice Address - Street 1:344 F ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2645
Practice Address - Country:US
Practice Address - Phone:619-585-4080
Practice Address - Fax:619-427-4572
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist