Provider Demographics
NPI:1295234987
Name:OLIVEROS, YUNNUEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:YUNNUEN
Middle Name:
Last Name:OLIVEROS
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 1:3555 KENYON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5341
Mailing Address - Country:US
Mailing Address - Phone:619-717-1406
Mailing Address - Fax:888-557-2908
Practice Address - Street 1:3555 KENYON ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5341
Practice Address - Country:US
Practice Address - Phone:619-717-1406
Practice Address - Fax:888-557-2908
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist