Provider Demographics
NPI:1649206269
Name:WIKSTEN, DENISE ANN (PHD, ATC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:WIKSTEN
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Gender:F
Credentials:PHD, ATC
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Mailing Address - Street 1:5500 CAMPANILE DR
Mailing Address - Street 2:DEPT. OF EXERCISE & NUTRITIONAL SCIENCES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92182-0001
Mailing Address - Country:US
Mailing Address - Phone:619-594-6825
Mailing Address - Fax:619-594-6623
Practice Address - Street 1:5500 CAMPANILE DR
Practice Address - Street 2:DEPT. OF EXERCISE & NUTRITIONAL SCIENCES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92182-0001
Practice Address - Country:US
Practice Address - Phone:619-594-6825
Practice Address - Fax:619-594-6623
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer