Provider Demographics
NPI:1972003101
Name:STUDLEY, DAKOTA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAKOTA
Middle Name:
Last Name:STUDLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DAKOTA
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3070 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2310
Mailing Address - Country:US
Mailing Address - Phone:760-591-7750
Mailing Address - Fax:760-471-5139
Practice Address - Street 1:850 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-1968
Practice Address - Country:US
Practice Address - Phone:760-789-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT294388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist