Provider Demographics
NPI:1407193519
Name:GRESIK, FRANCESCA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:MARIE
Last Name:GRESIK
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 1:11275 AFFINITY CT UNIT 111
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2723
Mailing Address - Country:US
Mailing Address - Phone:760-421-8700
Mailing Address - Fax:
Practice Address - Street 1:8901 ACTIVITY RD
Practice Address - Street 2:STE. D
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4427
Practice Address - Country:US
Practice Address - Phone:619-535-6900
Practice Address - Fax:619-535-6901
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB221208Medicare PIN
CACA131995Medicare PIN