Provider Demographics
NPI:1174179550
Name:WORRALL, KATHLEEN SUN (DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:SUN
Last Name:WORRALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DIAMOND CREEK PL
Mailing Address - Street 2:STE 125
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7188
Mailing Address - Country:US
Mailing Address - Phone:916-206-3612
Mailing Address - Fax:
Practice Address - Street 1:310 W 72ND ST STE 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2675
Practice Address - Country:US
Practice Address - Phone:212-353-8693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist