Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Moncada Tanaka, DPT

Individual provider Physical Therapist · NPI 1558924217

Nicole Moncada Tanaka, DPT is a Physical Therapist in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2019
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3020 Childrens Way # MC5068
San Diego, CA 92123-4223
Phone: (858) 966-5829
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT296235 (CA)

Record details

NPI number1558924217
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedApril 18, 2019
Last updated in NPPESApril 18, 2019

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