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General NPI Number Information
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NPI Number | 1699571588
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Entity Type | Individual
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Provider Name | KIERRA HOUSTON
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Gender |
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 18682 BEACH BLVD STE 160
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-2077
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Country | US
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Telephone | 714-794-7161
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Fax |
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Provider Business Mailing Address
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Address Line | 5776 CENTERSTONE CT
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City | WESTMINSTER
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State | CA
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Zip | 92683-9515
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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 | 53263
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License Number State | CA
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