Healthcare Provider Details

I. General information

NPI: 1326742313
Provider Name (Legal Business Name): KATIE LANGYI QIU DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 03/17/2024
Certification Date: 03/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WILSON RD STE C
MONTEREY CA
93940-7864
US

IV. Provider business mailing address

480 LAS TUNAS DR
ARCADIA CA
91007-8429
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-1885
  • Fax:
Mailing address:
  • Phone: 626-823-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number304301
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP21549
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: