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NPI Code Detail

MEDICARE: MRS. KATHY IRVINE WEINER P.T.

MEDICARE: MRS. KATHY IRVINE WEINER P.T.
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 TherapistPT 13831CA

General Provider Information

NPI Number : 1881867166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHY IRVINE WEINER P.T.
Provider Business Mailing Address
First Line : 3075 E THOUSAND OAKS BLVD
Second Line : SUITE 30
City : THOUSAND OAKS
State : CA
Zip : 91362-3402
Country : US
Telephone Number : 805-230-8292
Fax Number : 805-230-8294
Provider Business Practice Location Address
First Line : 2840 E LOS ANGELES AVE
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-3937
Country : US
Telephone Number : 805-526-8360
Fax Number : 805-526-1438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 04/08/2008

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