Provider Demographics
NPI:1891303970
Name:FESTER, KATHERINE MAUREEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAUREEN
Last Name:FESTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MAUREEN
Other - Last Name:FESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23456 HAWTHORNE BLVD
Mailing Address - Street 2:#200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-742-8388
Mailing Address - Fax:310-742-8388
Practice Address - Street 1:23456 HAWTHORNE BLVD
Practice Address - Street 2:#200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-742-8388
Practice Address - Fax:310-742-8388
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist