Provider Demographics
NPI:1396188173
Name:WITHAM, CHELSEA BARROW (DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BARROW
Last Name:WITHAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:MARION
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 10TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2359
Mailing Address - Country:US
Mailing Address - Phone:858-761-2992
Mailing Address - Fax:
Practice Address - Street 1:6070 AVENIDA ENCINAS
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1001
Practice Address - Country:US
Practice Address - Phone:760-444-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist