Provider Demographics
NPI:1881000248
Name:GEORGE, KATHERINE (MS, ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1201
Mailing Address - Country:US
Mailing Address - Phone:951-222-8135
Mailing Address - Fax:951-328-3616
Practice Address - Street 1:4800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1201
Practice Address - Country:US
Practice Address - Phone:951-222-8135
Practice Address - Fax:951-328-3616
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer