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General NPI Number Information
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NPI Number | 1427663137
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Entity Type | Individual
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Provider Name | CATHLEEN KATE EDRALIN DULAY PTA
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Gender | Female
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 1700 E BULLARD AVE STE 102
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City | FRESNO
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State | CA
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Zip | 93710-5866
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Country | US
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Telephone | 559-438-8531
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 N BLYTHE AVE APT 125
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City | FRESNO
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State | CA
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Zip | 93722-6376
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Country | US
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Telephone | 559-283-1284
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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 | 50819
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License Number State | CA
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