Provider Demographics
NPI:1346260593
Name:PERLSWEIG, KATHERINE ANNA (MS, ATC, LAT, CSCS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNA
Last Name:PERLSWEIG
Suffix:
Gender:F
Credentials:MS, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 TRIDENT WAY
Mailing Address - Street 2:BLDG 624
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92155-5493
Mailing Address - Country:US
Mailing Address - Phone:619-437-1404
Mailing Address - Fax:
Practice Address - Street 1:2000 TRIDENT WAY
Practice Address - Street 2:BLDG 624
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-5493
Practice Address - Country:US
Practice Address - Phone:619-437-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL30452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer