Provider Demographics
NPI:1689975112
Name:RAINS, KATHLEEN MANNIX (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MANNIX
Last Name:RAINS
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 1:24232 CASTILLA LN
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3187 RED HILL AVE STE 200
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3454
Practice Address - Country:US
Practice Address - Phone:714-975-8011
Practice Address - Fax:714-975-8023
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist