| Doctor Name: | MRS. KATHERINE LEVINE NICKERSON |
| NPI Number: | 1891023859 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 17070 |
| Business Practice Address: | 20823 Stevens Creek Blvd Suite #200 Cupertino, CA - 950142108 |
| Business Phone Number: | 4082526076 |
| Business Fax Number: | 4082521159 |
| Mailing Address: | 487 Theta Ct, SAN JOSE |
| State: | CA |
| Postal Code: | 951234946 |
| Phone Number: | 4088333465 |
| Fax Number: | 4084400409 |
| NPI Enumeration Date: | 12/02/2009 |
| NPI Last Update Date: | 07/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 17070 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |