Provider Demographics
NPI:1578194924
Name:DALLA BETTA, SYDNEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:DALLA BETTA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 VIA SABINAS
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-1384
Mailing Address - Country:US
Mailing Address - Phone:805-794-8565
Mailing Address - Fax:
Practice Address - Street 1:3027 VIA SABINAS
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-1384
Practice Address - Country:US
Practice Address - Phone:805-794-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296672208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation