Provider Demographics
NPI:1659553188
Name:PALMER, DANA (DPT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:860 JAMACHA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-3224
Mailing Address - Country:US
Mailing Address - Phone:619-573-6373
Mailing Address - Fax:
Practice Address - Street 1:860 JAMACHA RD STE 203
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3224
Practice Address - Country:US
Practice Address - Phone:619-573-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZM1685225100000X
HIPT-3276225100000X
MP0015225100000X
CA291537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist