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General NPI Number Information
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NPI Number | 1194021840
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Entity Type | Individual
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Provider Name | DJUNA CATHERINE WATT P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 3441 VIA LIDO STE C
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4788
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Country | US
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Telephone | 949-675-2639
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Fax |
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Provider Business Mailing Address
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Address Line | 3419 VIA LIDO # 332
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3908
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Country | US
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Telephone | 949-675-2639
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19439
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License Number State | CA
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