Provider Demographics
NPI:1518179357
Name:HIGH, KATHERINE (RPT, OTR)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HIGH
Suffix:
Gender:F
Credentials:RPT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 SANTA MONICA BLVD
Mailing Address - Street 2:950
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-4003
Mailing Address - Country:US
Mailing Address - Phone:310-455-1588
Mailing Address - Fax:310-455-1718
Practice Address - Street 1:21084 ENTRADA RD
Practice Address - Street 2:
Practice Address - City:TOPANGA
Practice Address - State:CA
Practice Address - Zip Code:90290-3531
Practice Address - Country:US
Practice Address - Phone:310-455-1588
Practice Address - Fax:310-455-1718
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5113225100000X
CA5288225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist