Provider Demographics
NPI:1447977152
Name:KOTT, VICTORIA BROOKE (DPT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:BROOKE
Last Name:KOTT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6473 SULU CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1936
Mailing Address - Country:US
Mailing Address - Phone:408-466-9143
Mailing Address - Fax:
Practice Address - Street 1:917 SAN RAMON VALLEY BLVD STE 190
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4032
Practice Address - Country:US
Practice Address - Phone:925-552-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist