Provider Demographics
NPI:1174536627
Name:ARGUELLES, EDITH CAUSING (PT)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:CAUSING
Last Name:ARGUELLES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:ARGUELLES
Other - Last Name:DEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1060 PASSIFLORA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2214
Mailing Address - Country:US
Mailing Address - Phone:760-542-5453
Mailing Address - Fax:760-456-9739
Practice Address - Street 1:1060 PASSIFLORA AVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2214
Practice Address - Country:US
Practice Address - Phone:760-542-5453
Practice Address - Fax:760-456-9739
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 17146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 17146Medicare ID - Type Unspecified