1154505584 NPI number — MRS. KATHERINE ELAINE CUTTS CMT

Table of content: MRS. KATHERINE ELAINE CUTTS CMT (NPI 1154505584)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154505584 NPI number — MRS. KATHERINE ELAINE CUTTS CMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUTTS
Provider First Name:
KATHERINE
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEBB
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
ELAINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154505584
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 188
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNTAIN MESA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93240-0188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-379-4267
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12308 MOUNTAIN MESA ROAD
Provider Second Line Business Practice Location Address:
B
Provider Business Practice Location Address City Name:
MOUNTAIN MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93240-0188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-379-4267
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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