Individual provider Active NPI

Kathy Leone, PT

  • Pediatric Physical Therapist
  • Santa Rosa, CA
National Provider Identifier
1790064525
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT5569 Issued in CA
Practice address
2999 Cleveland Ave
Suite D
Santa Rosa, CA 95403-2761
Phone
(707) 546-9160
Fax
(707) 546-1338
NPI assigned
Aug 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5569 CA
Pediatric Physical Therapist 2251P0200X PT5569 CA Primary

Addresses

Primary practice location

2999 Cleveland Ave
Suite D
Santa Rosa, CA 95403-2761

Mailing address

4301 Gravenstein Hwy N
Sebastopol, CA 95472-2206
Phone (707) 829-4731

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT5569CAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1790064525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GRAVENSTEIN HWY N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722206",
            "telephone_number": "707-829-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 CLEVELAND AVE",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032761",
            "telephone_number": "707-546-9160",
            "fax_number": "707-546-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONE",
        "first_name": "KATHY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT5569",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT5569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.