Healthcare Provider Details

I. General information

NPI: 1356464796
Provider Name (Legal Business Name): KRISTI AYARS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 ESPLANADE # A
CHICO CA
95926-3328
US

IV. Provider business mailing address

1263 ESPLANADE # A
CHICO CA
95926-3328
US

V. Phone/Fax

Practice location:
  • Phone: 530-520-3792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT23905
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP84640
License Number StateCA

VIII. Authorized Official

Name: KRISTI AYARS
Title or Position: OWNER
Credential: PT, DPT
Phone: 530-520-3792