Provider Demographics
NPI:1366255143
Name:GACOT, KATHRINA JESY ANN GUARIN (PT)
Entity type:Individual
Prefix:
First Name:KATHRINA JESY ANN
Middle Name:GUARIN
Last Name:GACOT
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 1:150 PALM VALLEY BLVD APT 1150
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1062
Mailing Address - Country:US
Mailing Address - Phone:806-776-8563
Mailing Address - Fax:
Practice Address - Street 1:150 PALM VALLEY BLVD APT 1150
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1062
Practice Address - Country:US
Practice Address - Phone:806-776-8563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050057225100000X
CA307517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist