Provider Demographics
NPI:1700533833
Name:APOSTOL, KATHLEEN DYAN LACSINA
Entity Type:Individual
Prefix:
First Name:KATHLEEN DYAN
Middle Name:LACSINA
Last Name:APOSTOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24547 LOS ALISOS BLVD APT 270
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7213
Mailing Address - Country:US
Mailing Address - Phone:949-235-5588
Mailing Address - Fax:
Practice Address - Street 1:24547 LOS ALISOS BLVD APT 270
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7213
Practice Address - Country:US
Practice Address - Phone:949-235-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23302225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist