Provider Demographics
NPI:1962928275
Name:COHEN, CATHERINE ELIZABETH (MS, ATC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:1345 CABRILLO PARK DR APT L15
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3132
Mailing Address - Country:US
Mailing Address - Phone:714-651-3715
Mailing Address - Fax:
Practice Address - Street 1:1345 CABRILLO PARK DR APT L15
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3132
Practice Address - Country:US
Practice Address - Phone:714-651-3715
Practice Address - Fax:714-651-3715
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer