Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 34369 | CA |
NPI | 1144528274 |
---|---|
Provider Name | Mrs. Katherine V Ongsingco |
First Address | Sylmar, CA 91342-5498 |
Second Address | Sylmar, CA 91342-5498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2011 |
Last Update Date | 05/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PT34369 | LICENSE (01) | CA |