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General NPI Number Information
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NPI Number | 1295609550
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Entity Type | Individual
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Provider Name | KATRINA RAEANN SUDIA DPT
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Gender | Female
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 475 PIONEER AVE STE 400
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City | WOODLAND
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State | CA
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Zip | 95776-4905
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Country | US
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Telephone | 916-878-1917
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Fax |
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Provider Business Mailing Address
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Address Line | 35125 95TH AVE
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City | SAINT JOSEPH
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State | MN
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Zip | 56374-9783
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 308997
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License Number State | CA
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