Healthcare Provider Details

I. General information

NPI: 1992619373
Provider Name (Legal Business Name): KAYLEE RENAE DEMARCHI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 E ALOSTA AVE
AZUSA CA
91702-2709
US

IV. Provider business mailing address

910 E ALOSTA AVE
AZUSA CA
91702-2709
US

V. Phone/Fax

Practice location:
  • Phone: 626-334-8735
  • Fax: 626-334-8906
Mailing address:
  • Phone: 626-334-8735
  • Fax: 626-334-8906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number308469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: