MEDICARE: KASI ROSE VELASCO PT

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	309732	CA

General Provider Information

NPI Number	:	1659223105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASI ROSE VELASCO PT

Provider Business Mailing Address
First Line	:	2839 LAKERIDGE CT
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-7864
Country	:	US
Telephone Number	:	559-713-6806
Fax Number	:	559-713-6809

Provider Business Practice Location Address
First Line	:	1132 LELAND AVE
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-7811
Country	:	US
Telephone Number	:	559-684-0611
Fax Number	:	559-684-0612

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

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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