Provider Demographics
NPI:1942537436
Name:KATZMAN, LISA JANE (PT, MPT, CIIM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JANE
Last Name:KATZMAN
Suffix:
Gender:F
Credentials:PT, MPT, CIIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 SHADELANDS DR BLDG 10
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 GRAND AVE STE 225
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3769
Practice Address - Country:US
Practice Address - Phone:408-826-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT164262251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics