Active NPI
Katelyn Harris
- Physical Therapist
- San Diego, CA
National Provider Identifier
1225913023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 308509
- Practice address
- 1601 Kettner Blvd Unit 11
San Diego, CA 92101-2539 - Phone
- (619) 544-1055
- NPI assigned
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 308509 | CA | Primary |
Addresses
Primary practice location
1601 Kettner Blvd Unit 11
San Diego, CA 92101-2539
Mailing address
4317 Miriam PL
La Mesa, CA 91941-6941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1601 Kettner Blvd
Unit 11
San Diego, CA 92101-2539
Phone (619) 544-1055
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308509 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Effect PC | Single Specialty | Current | Accepting new patients |
| Adams Physical Therapy | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1225913023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4317 MIRIAM PL",
"city": "LA MESA",
"state": "CA",
"postal_code": "919416941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 KETTNER BLVD UNIT 11",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012539",
"telephone_number": "619-544-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KATELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-11",
"last_updated": "2025-08-11",
"certification_date": "2025-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CA",
"license": "308509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.