Healthcare Provider Details
I. General information
NPI: 1407819394
Provider Name (Legal Business Name): CATHERINE ERIA BRUNSWICK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/11/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16950 VIA TAZON
SAN DIEGO CA
92127-1607
US
IV. Provider business mailing address
FILE 57326
LOS ANGELES CA
90074-7326
US
V. Phone/Fax
- Phone: 800-926-8273
- Fax: 888-539-8781
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 43589 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: