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Marcella Raquel Oden, PT,DPT,DACM,LAC
Military Health Care Provider in San Diego, California
NPI 1316929060

Marcella Raquel Oden is a Military Health Care Provider based in Coronado, CA. Marcella Raquel Oden practices in San Diego, CA and has the professional credentials of PT,DPT,DACM,LAC. The NPI Number for Marcella Raquel Oden is 1316929060 and holds a License No. 27789 (California).

The current practice location address for Marcella Raquel Oden is 4415 Genesee Ave, San Diego, CA and can be reached out via phone at 619-800-1974.

Location: 4415 Genesee Ave, San Diego, CA, 92118-1925
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316929060
Provider Name
Marcella Raquel Oden
Credential
PT,DPT,DACM,LAC
Provider Entity Type
Individual
Gender
Female
Address
4415 Genesee Ave, San Diego, CA, 92118-1925
Phone Number
619-800-1974
Fax Number
Provider Enumeration Date
11/17/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19467 01 CA ACUPUNCTURE LICENSE
AP4491 01 FL ACUPUNCTURE LICENSE
PT27789 01 CA PHYSICAL THERAPY LICENSE
institution
Provider Business Practice Location Address Details
Address
4415 Genesee Ave
City
San Diego
State
California
Zip
92117-3005
Phone Number
619-800-1974
Fax Number
person
Provider Business Mailing Address Details
Address
4415 Genesee Ave
City
San Diego
State
California
Zip
92117-3005
Phone Number
619-800-1974
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
PT27789 (California)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Acupuncturist
Speciality
-
Taxonomy
171100000X
License No.
19467 (California)
Definition
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
person
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Physical Therapist
Speciality
Orthopedic
Taxonomy
2251X0800X
License No.
27789 (California)
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
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