Provider Demographics
NPI:1376932905
Name:PHI, KATHY (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:KATHY
Middle Name:
Last Name:PHI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15801 BUTTERFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6932
Mailing Address - Country:US
Mailing Address - Phone:714-622-0491
Mailing Address - Fax:
Practice Address - Street 1:15801 BUTTERFIELD ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6932
Practice Address - Country:US
Practice Address - Phone:714-622-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14934225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist