Provider Demographics
NPI:1134426885
Name:MEEKS, KATHRYN M (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:MEEKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15215 NATIONAL AVE
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2425
Mailing Address - Country:US
Mailing Address - Phone:408-358-7345
Mailing Address - Fax:408-358-7349
Practice Address - Street 1:15215 NATIONAL AVE
Practice Address - Street 2:SUITE 100A
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2425
Practice Address - Country:US
Practice Address - Phone:408-358-7345
Practice Address - Fax:408-358-7349
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 13090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEX316ZMedicare PIN