Healthcare Provider Details

I. General information

NPI: 1538094594
Provider Name (Legal Business Name): KATARINA AVERY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 ATLANTIC AVE
LONG BEACH CA
90813-4546
US

IV. Provider business mailing address

13034 POINT REYES PL
CERRITOS CA
90703-8710
US

V. Phone/Fax

Practice location:
  • Phone: 562-549-9852
  • Fax:
Mailing address:
  • Phone: 702-416-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279E1000X
TaxonomyEducational Registered Respiratory Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: