Healthcare Provider Details

I. General information

NPI: 1265958151
Provider Name (Legal Business Name): KATRINA LEE YUN XIN WILKINS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 EL CAMINO REAL
PALO ALTO CA
94306-3324
US

IV. Provider business mailing address

798 TRENTON DR
SUNNYVALE CA
94087-2253
US

V. Phone/Fax

Practice location:
  • Phone: 650-565-8090
  • Fax:
Mailing address:
  • Phone: 408-781-3024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251H1300X
TaxonomyHuman Factors Physical Therapist
License Number038086-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT296730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: