Provider Demographics
NPI:1477715217
Name:BURKE-DOE, ANNIE PATRICE (PT, PHD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:PATRICE
Last Name:BURKE-DOE
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 PORTAGE WAY
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4671
Mailing Address - Country:US
Mailing Address - Phone:760-602-6121
Mailing Address - Fax:
Practice Address - Street 1:625 W CITRACADO PKWY
Practice Address - Street 2:SUITE 102, PHYSICAL THERAPY DEPARTMENT
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6428
Practice Address - Country:US
Practice Address - Phone:760-294-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA188502251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics