Melissa Eileen Fitzgibbon, MS, LAT, ATC
Specialist/Technologist, Athletic Trainer in San Diego, CA. Individual provider (NPI-1).
NPI number1689288136
StatusActive
Last updated in NPPESMar 18, 2023
Details
- NPI
- 1689288136
- Entity type
- Individual (NPI-1)
- Name
- Melissa Eileen Fitzgibbon
- Credential
- MS, LAT, ATC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 2, 2020
- Certification date
- Mar 18, 2023
- Last updated
- Mar 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | RTO000553 | PA | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 13005003-4810 | UT |
Practice location
9550 Carmel Mountain RdSan Diego, CA 92129-2799
Phone 858-484-1180
Mailing address
1259 Calle UltimoOceanside, CA 92056-5633
Phone 760-994-3820
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