Provider Demographics
NPI:1467070821
Name:WILKINS, DIONISIO (DPT)
Entity Type:Individual
Prefix:
First Name:DIONISIO
Middle Name:
Last Name:WILKINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 KEARNY VILLA RD APT 158
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1975
Mailing Address - Country:US
Mailing Address - Phone:253-306-9732
Mailing Address - Fax:
Practice Address - Street 1:3455 KEARNY VILLA RD APT 158
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1975
Practice Address - Country:US
Practice Address - Phone:253-306-9732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist