Katherine Colletto, P.T.

Individual provider Active NPI Physical Therapist · Granada Hills, CA

NPI 1477511376 · NPPES record last updated Feb 10, 2011

Key facts

NPI
1477511376
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT6758 (CA)
Practice address
16692 Knollwood Dr
Granada Hills, CA 91344-2621
Phone
(818) 368-2942
Fax
(818) 368-2942
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT6758CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6758 CA Yes

Addresses

Primary practice location

16692 Knollwood Dr
Granada Hills, CA 91344-2621

Mailing address

16692 Knollwood Dr
Granada Hills, CA 91344-2621
Phone (818) 368-2942

Other identifiers

IdentifierTypeStateIssuer
PT6758OtherCALICENSE TO PRACTICE

Other names

  • Katherine Prentice Former name

Other providers in Granada Hills, CA

All providers in Granada Hills, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.