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NPI Code Detail

MEDICARE: KRISTI LYNN LEWIS ROSALES PTA

MEDICARE: KRISTI LYNN LEWIS ROSALES PTA
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
1225200000XPhysical Therapy AssistantAT1925CA

General Provider Information

NPI Number : 1245059484
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI LYNN LEWIS ROSALES PTA
Provider Business Mailing Address
First Line : 2109 POINSETTIA ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-2923
Country : US
Telephone Number : 562-682-5604
Fax Number :
Provider Business Practice Location Address
First Line : 1929 N FAIRVIEW ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-2205
Country : US
Telephone Number : 714-554-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2024
Last Update Date : 10/04/2024

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