Kathryn Deagon
Physical Therapist in Long Beach, CA. Individual provider (NPI-1).
NPI number1245579366
StatusActive
Last updated in NPPESOct 27, 2020
Details
- NPI
- 1245579366
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kathryn Deagon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2013
- Certification date
- Oct 27, 2020
- Last updated
- Oct 27, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 13577 | CA | Yes |
Practice location
330 Golden Shr Ste 250Long Beach, CA 90802-4270
Phone 562-256-7550
Mailing address
10442 Cantara StSun Valley, CA 91352-4112
Phone 818-331-7485
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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