Provider Demographics
NPI:1851676712
Name:LINEHAN-JANZEN, KATHLEEN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:LINEHAN-JANZEN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:LINEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:2270 DOUGLAS BLVD
Mailing Address - Street 2:# 112
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3869
Mailing Address - Country:US
Mailing Address - Phone:916-782-1212
Mailing Address - Fax:916-782-0695
Practice Address - Street 1:4990 ROCKLIN RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4315
Practice Address - Country:US
Practice Address - Phone:916-632-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38169225100000X
CO4812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist