Provider Demographics
NPI:1376701763
Name:LILIENSTEIN, KATHLEEN SUMIMOTO (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:SUMIMOTO
Last Name:LILIENSTEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3704
Mailing Address - Country:US
Mailing Address - Phone:415-566-1200
Mailing Address - Fax:415-566-1364
Practice Address - Street 1:1575 7TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3704
Practice Address - Country:US
Practice Address - Phone:415-566-1200
Practice Address - Fax:415-566-1364
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist