Kathleen Ikuta, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

41709 Issued in CA

Practice address

1650 S Amphlett Blvd Ste 108
San Mateo, CA 94402-2514

Phone

(650) 638-9142

Fax

(650) 638-9141

NPI assigned

Sep 22, 2014

Last updated

Sep 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1396147278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S AMPHLETT BLVD STE 108",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022514",
            "telephone_number": "650-638-9142",
            "fax_number": "650-638-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S AMPHLETT BLVD STE 108",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022514",
            "telephone_number": "650-638-9142",
            "fax_number": "650-638-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUTA",
        "first_name": "KATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "41709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Gange Ibarrientos, R.N.
• Joseph Ibe, D.C.
• Ilona Ignatjeva
• Moira Ikeda, CCC-SLP
• Shannon Keiko Ikeda
• Jun Mee Im
• Shirin Shahinfar Imani, DDS
• Immediate Medical Care Inc
• Michael Stuart Immerman, MSW
• Impakt Medical, LLC (Impakt Medical)

• Pediatric Physical Therapist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.