Provider Demographics
NPI:1801916119
Name:KERFOOT, LISA LOUISE (DPT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LOUISE
Last Name:KERFOOT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LOUISE
Other - Last Name:FRITSCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26592 VIA CUERVO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2910
Mailing Address - Country:US
Mailing Address - Phone:949-257-8400
Mailing Address - Fax:
Practice Address - Street 1:980 ROOSEVELT
Practice Address - Street 2:STE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3670
Practice Address - Country:US
Practice Address - Phone:949-333-6403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist