Healthcare Provider Details

I. General information

NPI: 1346225224
Provider Name (Legal Business Name): KATHLEEN JEAN MORGAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 MAIN ST STE. 105
RAMONA CA
92065-1968
US

IV. Provider business mailing address

3070 MADISON ST
CARLSBAD CA
92008-2310
US

V. Phone/Fax

Practice location:
  • Phone: 760-789-1424
  • Fax: 760-789-1463
Mailing address:
  • Phone: 760-434-6100
  • Fax: 760-434-4583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT22583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: