Healthcare Provider Details

I. General information

NPI: 1427386549
Provider Name (Legal Business Name): KIMBERLY C KUJAWA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24331 EL TORO RD STE 200
LAGUNA WOODS CA
92637-3116
US

IV. Provider business mailing address

24331 EL TORO RD STE 200
LAGUNA WOODS CA
92637-3116
US

V. Phone/Fax

Practice location:
  • Phone: 949-586-3200
  • Fax: 949-900-2116
Mailing address:
  • Phone: 949-586-3200
  • Fax: 949-900-2116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310145
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-30268
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1031888
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: