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General NPI Number Information
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NPI Number | 1205446309
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Entity Type | Individual
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Provider Name | KATIE CAMPAGNA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 3445 PACIFIC COAST HWY STE 310
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City | TORRANCE
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State | CA
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Zip | 90505-6660
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Country | US
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Telephone | 310-370-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 10664 SAINT JAMES DR
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City | CULVER CITY
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State | CA
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Zip | 90230-5498
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 50628
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 306835
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License Number State | CA
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