Provider Demographics
NPI:1528289907
Name:MCDONOUGH, KATHLEEN HOPE (MA, PT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:HOPE
Last Name:MCDONOUGH
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Gender:F
Credentials:MA, PT
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Mailing Address - Street 1:114 MEADOWCROFT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1507
Mailing Address - Country:US
Mailing Address - Phone:415-272-3966
Mailing Address - Fax:415-785-7012
Practice Address - Street 1:224 GREENFIELD AVE STE 1
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2472
Practice Address - Country:US
Practice Address - Phone:415-272-3966
Practice Address - Fax:415-457-4200
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2019-04-28
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Provider Licenses
StateLicense IDTaxonomies
CA122662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic