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NPI Code Detail

MEDICARE: KATIE ELIZABETH BOOTH DPT

MEDICARE: KATIE ELIZABETH BOOTH DPT
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
1225100000XPhysical TherapistPT305843CA

General Provider Information

NPI Number : 1679351209
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE ELIZABETH BOOTH DPT
Provider Business Mailing Address
First Line : 3600 OCEAN RANCH BLVD
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-2669
Country : US
Telephone Number : 760-696-3376
Fax Number : 877-559-5308
Provider Business Practice Location Address
First Line : 5850 EL CAMINO REAL STE 111
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-8816
Country : US
Telephone Number : 760-542-2414
Fax Number : 760-542-2415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2023
Last Update Date : 01/22/2026

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