Provider Demographics
NPI:1033618061
Name:NAFICY, KATHLEEN MONAHAN (PT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MONAHAN
Last Name:NAFICY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 165
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3670
Mailing Address - Country:US
Mailing Address - Phone:949-951-2770
Mailing Address - Fax:949-951-2976
Practice Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 165
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3670
Practice Address - Country:US
Practice Address - Phone:949-951-2770
Practice Address - Fax:949-951-2976
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist