Provider Demographics
NPI:1992942031
Name:CHMIELEWSKI, KASIA (PTA)
Entity type:Individual
Prefix:
First Name:KASIA
Middle Name:
Last Name:CHMIELEWSKI
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 1:3154 MEYERLOA LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1135
Mailing Address - Country:US
Mailing Address - Phone:818-209-0951
Mailing Address - Fax:
Practice Address - Street 1:3154 MEYERLOA LN
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1135
Practice Address - Country:US
Practice Address - Phone:818-209-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6133225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant