Provider Demographics
NPI:1770596082
Name:KATZ, ELISHEVA (PT)
Entity type:Individual
Prefix:MS
First Name:ELISHEVA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0858
Mailing Address - Country:US
Mailing Address - Phone:530-692-0601
Mailing Address - Fax:530-758-7212
Practice Address - Street 1:9230 MARYSVILLE RD
Practice Address - Street 2:
Practice Address - City:OREGON HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95962-9705
Practice Address - Country:US
Practice Address - Phone:530-692-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist