Provider Demographics
NPI:1497390355
Name:BRUNN, CAITLYN (DPT)
Entity type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:
Last Name:BRUNN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 HONEYSUCKLE WAY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1505
Mailing Address - Country:US
Mailing Address - Phone:760-855-9365
Mailing Address - Fax:
Practice Address - Street 1:800 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3421
Practice Address - Country:US
Practice Address - Phone:760-747-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist