Individual
ROBERTA RAE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1120 VIA CALLEJON, SUITE B, SAN CLEMENTE, CA 92673-6213
(949) 498-5100
Mailing address
1120 VIA CALLEJON, SUITE B, SAN CLEMENTE, CA 92673-6213
(949) 498-5100
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
14647
CA
Other
Enumeration date
03/06/2007
Last updated
02/28/2012
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