Provider Demographics
NPI:1881452340
Name:CAPA, DARLA JEAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:DARLA JEAN
Middle Name:
Last Name:CAPA
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 1:1264 BOCA RATON DR
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2115
Mailing Address - Country:US
Mailing Address - Phone:619-757-0444
Mailing Address - Fax:
Practice Address - Street 1:1264 BOCA RATON DR
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2115
Practice Address - Country:US
Practice Address - Phone:619-757-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist