Individual
MATTHEW CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1145 CAMINO PRADO, CHULA VISTA, CA 91913-3823
(619) 216-6550
Mailing address
13069 EVENING CREEK DR S UNIT 57, SAN DIEGO, CA 92128-8122
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
15899
CA
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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