Provider Demographics
NPI:1457924698
Name:FARLEY, JOLENE ANTOINETTE (DPT)
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:ANTOINETTE
Last Name:FARLEY
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 1:2719 LOKER AVE W
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6678
Mailing Address - Country:US
Mailing Address - Phone:760-918-9200
Mailing Address - Fax:
Practice Address - Street 1:2719 LOKER AVE W
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6678
Practice Address - Country:US
Practice Address - Phone:760-918-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist