Provider Demographics
NPI:1811390859
Name:KAUL, BRITTANIE (ATC)
Entity type:Individual
Prefix:
First Name:BRITTANIE
Middle Name:
Last Name:KAUL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37764 COLEBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-2028
Mailing Address - Country:US
Mailing Address - Phone:760-861-3331
Mailing Address - Fax:
Practice Address - Street 1:86150 66TH AVE
Practice Address - Street 2:
Practice Address - City:THERMAL
Practice Address - State:CA
Practice Address - Zip Code:92274-9626
Practice Address - Country:US
Practice Address - Phone:760-397-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-05
Last Update Date:2014-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer