Provider Demographics
NPI:1427205376
Name:PADILLA, SAMANTHA KAY (PT, DPT, CCI)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KAY
Last Name:PADILLA
Suffix:
Gender:F
Credentials:PT, DPT, CCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 ALTAMIRA PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1202
Mailing Address - Country:US
Mailing Address - Phone:513-519-3923
Mailing Address - Fax:
Practice Address - Street 1:4393 IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-1962
Practice Address - Country:US
Practice Address - Phone:619-908-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10546174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist