Provider Demographics
NPI:1386455301
Name:PADILLA UTRERAS, DEBBIE CAROLINA (ATC, LAT)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:CAROLINA
Last Name:PADILLA UTRERAS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 VICTORY LAP LN APT 204
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7070
Mailing Address - Country:US
Mailing Address - Phone:862-201-9442
Mailing Address - Fax:
Practice Address - Street 1:2 MARDIV, 6TH REG, HQCO
Practice Address - Street 2:PSC BOX 20097
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28542
Practice Address - Country:US
Practice Address - Phone:910-451-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT002761002255A2300X
NY0048782255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer