Provider Demographics
NPI:1225691827
Name:DUONG, KATHY
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 E MAIN ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4082
Mailing Address - Country:US
Mailing Address - Phone:888-511-0898
Mailing Address - Fax:
Practice Address - Street 1:726 E MAIN ST UNIT A
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4082
Practice Address - Country:US
Practice Address - Phone:888-511-0898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2025-10-31
Deactivation Date:2025-05-15
Deactivation Code:
Reactivation Date:2025-10-29
Provider Licenses
StateLicense IDTaxonomies
CA24003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist