Theresa R Pulickal, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 36474 Issued in CA

Practice address

7862 El Cajon Blvd
La Mesa, CA 91942-6712

Phone

(619) 644-6452

Fax

(619) 466-7528

NPI assigned

Apr 21, 2010

Last updated

Jun 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tamimi Medical Group

  dba Silver Strand Wellness Center, APMC

  • Physical Medicine & Rehabilitation Physician
  • Imperial Beach, CA
  • NPI 1497985352
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1093032781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 RIVIERA DR",
            "address_2": "UNIT G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095835",
            "telephone_number": "773-771-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7862 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426712",
            "telephone_number": "619-644-6452",
            "fax_number": "619-466-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULICKAL",
        "first_name": "THERESA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 36474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Provenzano, MSN, FNP- C
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• Gabriela Alexa Puentes, OTR/L
• Savannah Puett, DDS
• Pulmonary Associates Medical Group, Inc
• Man Y Pun, DDS
• Purushotham and Akther J Kotha M D Inc
• Paul Arthur Pyka, D.O.
• Elaine M Quattro, MFT

• Physical Therapist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.