Provider Demographics
NPI:1891153565
Name:ACUNA, MARISA (DPT)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:ACUNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 TOPA TOPA CT
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1147
Mailing Address - Country:US
Mailing Address - Phone:805-320-6814
Mailing Address - Fax:
Practice Address - Street 1:775 TOPA TOPA CT
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1147
Practice Address - Country:US
Practice Address - Phone:805-320-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist