Individual
MRS. CONSUELO ANN ANAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
7607 LA JOLLA BLVD, LA JOLLA, CA 92037-4703
(858) 459-4021
Mailing address
9916 VIA CUENCA, SAN DIEGO, CA 92129-2743
(623) 680-0089
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
020002224
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020002224
ATHLETIC TRAINER
CA
Enumeration date
05/04/2015
Last updated
01/28/2021
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