Provider Demographics
NPI:1427663137
Name:DULAY, CATHLEEN KATE EDRALIN (PTA)
Entity type:Individual
Prefix:
First Name:CATHLEEN KATE
Middle Name:EDRALIN
Last Name:DULAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 N BLYTHE AVE APT 125
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6376
Mailing Address - Country:US
Mailing Address - Phone:559-283-1284
Mailing Address - Fax:
Practice Address - Street 1:1700 E BULLARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5866
Practice Address - Country:US
Practice Address - Phone:559-438-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50819225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant