Provider Demographics
NPI:1942831375
Name:MOSES, KATHERINE MACKENZIE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MACKENZIE
Last Name:MOSES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MACKENZIE
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:18030 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5603
Mailing Address - Country:US
Mailing Address - Phone:903-306-8831
Mailing Address - Fax:
Practice Address - Street 1:18030 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5603
Practice Address - Country:US
Practice Address - Phone:903-306-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist