Provider Demographics
NPI:1912060567
Name:MILANO, KATHLEEN LYNNE (DPT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:LYNNE
Last Name:MILANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 FUNSTON AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-5510
Mailing Address - Country:US
Mailing Address - Phone:831-601-0889
Mailing Address - Fax:
Practice Address - Street 1:21 UPPER RAGSDALE DR
Practice Address - Street 2:SUITE #125
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7831
Practice Address - Country:US
Practice Address - Phone:831-372-2963
Practice Address - Fax:831-656-9179
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26684225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT266840OtherBLUE SHIELD PIN NUMBER
CAPT26684OtherSTATE LICENSE
CA0PT266840OtherBLUE SHIELD PIN NUMBER