Individual
PENNY ROSE REPUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 25TH ST, SAN DIEGO, CA 92102-2107
(619) 233-0067
(619) 233-3990
Mailing address
1315 25TH ST, SAN DIEGO, CA 92102-2107
(619) 233-0067
(619) 233-3990
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-CTXBMY
CA
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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