Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theresa Ketterhagen, PT

Individual provider Physical Therapist · NPI 1235460767

Theresa Ketterhagen, PT is a Physical Therapist in Private Practice in Los Angeles, California. Qualified in 1984, 42 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
42
Licensed in
CA
In the registry since
2010
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

11677 San Vicente Blvd Ste 207
Los Angeles, CA 90049-5128
Phone: (310) 743-6649
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT12185 (CA)

Record details

NPI number1235460767
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedJanuary 22, 2010
Last updated in NPPESApril 16, 2021
Certification dateApril 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1984 (42 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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