Provider Demographics
NPI:1003960337
Name:CARREIRO, CATHERINE (PT, ATC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:CARREIRO
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21986 TOBARRA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 N. STATE COLLEGE BLVD
Practice Address - Street 2:SHCC-EAST RM 102
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92834-6830
Practice Address - Country:US
Practice Address - Phone:714-278-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist