Provider Demographics
NPI:1972612596
Name:GILLESPIE, CATHERINE (MPT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:GRIMLIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:317 N EL CAMINO REAL
Mailing Address - Street 2:STE 405
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2815
Mailing Address - Country:US
Mailing Address - Phone:858-300-8663
Mailing Address - Fax:
Practice Address - Street 1:11501 RANCHO BEINARDO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1404
Practice Address - Country:US
Practice Address - Phone:888-485-6706
Practice Address - Fax:888-485-7052
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist