Provider Demographics
NPI:1275934820
Name:NOCHTA, KATHLEEN ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:NOCHTA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5478 WILSHIRE BLVD
Mailing Address - Street 2:#208
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4229
Mailing Address - Country:US
Mailing Address - Phone:323-936-7525
Mailing Address - Fax:
Practice Address - Street 1:5478 WILSHIRE BLVD
Practice Address - Street 2:#208
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4229
Practice Address - Country:US
Practice Address - Phone:323-936-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist