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Contact Information

NICOLLETTE PENNER, DPT
15004 INNOVATION DRIVE
SAN DIEGO, CA92128
 Phone: 858-605-7189
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for NICOLLETTE PENNER · (Female)

NPI Number 1174155568
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 02/04/2020
Last updated 02/04/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 292631
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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