Provider Demographics
NPI:1891395836
Name:BUHAGIAR, KATRINA (DPT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:BUHAGIAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 CIVIC CT STE 320
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5230
Mailing Address - Country:US
Mailing Address - Phone:925-326-2211
Mailing Address - Fax:
Practice Address - Street 1:1470 CIVIC CT STE 320
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5230
Practice Address - Country:US
Practice Address - Phone:925-326-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist