MEDICARE: MISS CATHERINE DAVITT ATC,PTA,C.E.A.S.II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	AT3541	CA

General Provider Information

NPI Number	:	1497886485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CATHERINE DAVITT ATC,PTA,C.E.A.S.II

Provider Business Mailing Address
First Line	:	5474 DON ANDRES WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95123-3103
Country	:	US
Telephone Number	:	408-288-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1893 MONTEREY HWY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-6136
Country	:	US
Telephone Number	:	408-288-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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