Provider Demographics
NPI:1114246048
Name:PARSONS, KATRINA RENEE (MPT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:RENEE
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26457 VIA DAMASCO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2945
Mailing Address - Country:US
Mailing Address - Phone:949-722-8811
Mailing Address - Fax:949-722-9911
Practice Address - Street 1:26457 VIA DAMASCO
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2945
Practice Address - Country:US
Practice Address - Phone:949-722-8811
Practice Address - Fax:949-722-9911
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist