MEDICARE: KRISTIN KULAKOWSKI NAUTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1043696636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN KULAKOWSKI NAUTA

Provider Business Mailing Address
First Line	:	6811 SPICKARD DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5677
Country	:	US
Telephone Number	:	714-334-7493
Fax Number	:

Provider Business Practice Location Address
First Line	:	6082 EDINGER AVE STE 100
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-3264
Country	:	US
Telephone Number	:	714-334-7493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	02/17/2022

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