Provider Demographics
NPI:1659690212
Name:BRENNAN, CATHI E (MT)
Entity Type:Individual
Prefix:
First Name:CATHI
Middle Name:E
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 ARIANE DR UNIT 48
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3443
Mailing Address - Country:US
Mailing Address - Phone:619-889-4945
Mailing Address - Fax:
Practice Address - Street 1:2726 ARIANE DR UNIT 48
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3443
Practice Address - Country:US
Practice Address - Phone:619-889-4945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist