Provider Demographics
NPI:1912684325
Name:VINER, CHARLOTTE (DPT)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:VINER
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 1:1909 CARENNAC PL APT 55
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-5030
Mailing Address - Country:US
Mailing Address - Phone:408-355-0488
Mailing Address - Fax:
Practice Address - Street 1:11848 BERNARDO PLAZA CT STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2417
Practice Address - Country:US
Practice Address - Phone:858-217-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist