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Individual

DE ARA ANNISE WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3707 CONVOY ST, SAN DIEGO, CA 92111-3754
(858) 573-9368
Mailing address
3707 CONVOY ST, SAN DIEGO, CA 92111-3754
(619) 987-8584

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
10/04/2021
Last updated
06/13/2026
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