Provider Demographics
NPI:1679724967
Name:KAUT, KATHERINE MARY
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARY
Last Name:KAUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 VICTOR AVE
Mailing Address - Street 2:APT.A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4823
Mailing Address - Country:US
Mailing Address - Phone:530-222-3646
Mailing Address - Fax:530-222-8964
Practice Address - Street 1:1420 VICTOR AVE
Practice Address - Street 2:APT.A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4823
Practice Address - Country:US
Practice Address - Phone:530-222-3646
Practice Address - Fax:530-222-8964
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-05
Last Update Date:2008-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist