Provider Demographics
NPI:1063768968
Name:VALDEZ, KATHRYN LEIGH (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEIGH
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LEIGH
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:550 CAMINO EL ESTERO STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3231
Mailing Address - Country:US
Mailing Address - Phone:831-216-8944
Mailing Address - Fax:844-689-1142
Practice Address - Street 1:550 CAMINO EL ESTERO STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3231
Practice Address - Country:US
Practice Address - Phone:831-216-8944
Practice Address - Fax:844-689-1142
Is Sole Proprietor?:No
Enumeration Date:2012-07-28
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist