Healthcare Provider Details

I. General information

NPI: 1851708507
Provider Name (Legal Business Name): KRISTIN MICHELLE CRESS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 PAINTER AVE SUITE 200
WHITTIER CA
90602-3168
US

IV. Provider business mailing address

8135 PAINTER AVE SUITE 200
WHITTIER CA
90602-3158
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-6600
  • Fax: 562-698-6613
Mailing address:
  • Phone: 562-698-6600
  • Fax: 562-698-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number9921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: