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General NPI Number Information
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NPI Number | 1366017790
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Entity Type | Individual
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Provider Name | KATHERINE ELLEN PECSON P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 150 MUIR RD.
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City | MARTINEZ
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State | CA
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Zip | 94553
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Country | US
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Telephone | 925-372-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2839 JOHNSON AVE.
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City | ALAMEDA
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State | CA
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Zip | 94501
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Country | US
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Telephone | 510-205-3324
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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 | PT21176
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License Number State | CA
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