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NPI Code Detail

MEDICARE: KATIA NICOLE CORREA PT

MEDICARE: KATIA NICOLE CORREA PT
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 Therapist297002CA

General Provider Information

NPI Number : 1831744036
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIA NICOLE CORREA PT
Provider Business Mailing Address
First Line : 15000 KENSINGTON PARK DR
Second Line :
City : TUSTIN
State : CA
Zip : 92782-1830
Country : US
Telephone Number : 657-859-6458
Fax Number : 657-215-8480
Provider Business Practice Location Address
First Line : 15000 KENSINGTON PARK DR
Second Line :
City : TUSTIN
State : CA
Zip : 92782-1830
Country : US
Telephone Number : 657-859-6458
Fax Number : 657-215-8480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2019
Last Update Date : 05/29/2024

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Directions to “ KATIA NICOLE CORREA PT” Practice Location

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