Healthcare Provider Details

I. General information

NPI: 1396989158
Provider Name (Legal Business Name): KRISTINE HULME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

554 BLOSSOM HILL RD
SAN JOSE CA
95123-3212
US

IV. Provider business mailing address

2100 POWELL ST SUITE 900
EMERYVILLE CA
94608-1826
US

V. Phone/Fax

Practice location:
  • Phone: 408-281-2772
  • Fax:
Mailing address:
  • Phone: 510-350-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberAT5394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: