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NPI Code Detail

MEDICARE: KAY DARLENE GLENN PT

MEDICARE: KAY DARLENE GLENN 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 Therapist5375CA
22251P0200XPediatric Physical Therapist5375CA

General Provider Information

NPI Number : 1952359341
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAY DARLENE GLENN PT
Provider Business Mailing Address
First Line : 24242 LA CRESTA DR
Second Line :
City : DANA POINT
State : CA
Zip : 92629-2561
Country : US
Telephone Number : 949-496-3363
Fax Number :
Provider Business Practice Location Address
First Line : 24242 LA CRESTA DR
Second Line :
City : DANA POINT
State : CA
Zip : 92629-2561
Country : US
Telephone Number : 949-496-3363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 09/11/2025

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