Provider Demographics
NPI:1912290826
Name:ARELLANO, FUMI JUDITH (PT)
Entity Type:Individual
Prefix:
First Name:FUMI
Middle Name:JUDITH
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17860
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92177-7860
Mailing Address - Country:US
Mailing Address - Phone:800-787-6787
Mailing Address - Fax:800-787-6762
Practice Address - Street 1:9089 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1234
Practice Address - Country:US
Practice Address - Phone:800-787-6787
Practice Address - Fax:800-787-6762
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 15676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist