Provider Demographics
NPI:1356017172
Name:THIREY, KATHRYN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:THIREY
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 1:3501 HARBISON DR UNIT 901
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3934
Mailing Address - Country:US
Mailing Address - Phone:404-803-4996
Mailing Address - Fax:
Practice Address - Street 1:81 CERNON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-2803
Practice Address - Country:US
Practice Address - Phone:707-447-9750
Practice Address - Fax:707-447-9220
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015519225100000X, 2251P0200X
CAPT3048992251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics