Provider Demographics
NPI:1720485543
Name:BERIAU, KATHLEEN M (DPT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:BERIAU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:25231 PASEO DE ALICIA
Mailing Address - Street 2:STE 110
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4645
Mailing Address - Country:US
Mailing Address - Phone:949-716-4889
Mailing Address - Fax:949-716-4963
Practice Address - Street 1:25231 PASEO DE ALICIA
Practice Address - Street 2:STE 110
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4645
Practice Address - Country:US
Practice Address - Phone:949-716-4889
Practice Address - Fax:949-716-4963
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist