1962928275 NPI number — CATHERINE ELIZABETH COHEN MS, ATC

Table of content: CATHERINE ELIZABETH COHEN MS, ATC (NPI 1962928275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962928275 NPI number — CATHERINE ELIZABETH COHEN MS, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COHEN
Provider First Name:
CATHERINE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COHEN
Provider Other First Name:
KATY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, ATC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1962928275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1345 CABRILLO PARK DR APT L15
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92701-3132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-651-3715
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1345 CABRILLO PARK DR APT L15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92701-3132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-651-3715
Provider Business Practice Location Address Fax Number:
714-651-3715
Provider Enumeration Date:
08/17/2017

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: 2255A2300X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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