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General NPI Number Information
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NPI Number | 1902858772
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Entity Type | Individual
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Provider Name | KATHY JANE JOHNSON RPT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/16/2010
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Provider Practice Location Address
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Address Line | 1329 E THOUSAND OAKS BLVD SUITE 118
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2824
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Country | US
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Telephone | 805-551-0939
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Fax |
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Provider Business Mailing Address
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Address Line | 11224 BROADVIEW DR
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City | MOORPARK
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State | CA
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Zip | 93021-3723
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Country | US
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Telephone | 805-531-5047
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Fax | 805-654-8149
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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 | PT10753
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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