Healthcare Provider Details

I. General information

NPI: 1649902271
Provider Name (Legal Business Name): KATE HYOMIN PIERCE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 BROADWAY
CHULA VISTA CA
91910-3501
US

IV. Provider business mailing address

8380 CENTER DR STE E
LA MESA CA
91942-2952
US

V. Phone/Fax

Practice location:
  • Phone: 619-422-0404
  • Fax: 619-422-4153
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number302319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: