Provider Demographics
NPI:1679892020
Name:HIGGINS, DAWN MARIE (DPT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:DELAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 CENTRAL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2740
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:27450 YNEZ RD STE 120
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4649
Practice Address - Country:US
Practice Address - Phone:951-695-5144
Practice Address - Fax:951-695-9345
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36588226300000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36588OtherPHYSICAL THERAPY BOARD OF CALIFORNIA