MEDICARE: TREVOR STANDRIDGE KAYE

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	303828	CA

General Provider Information

NPI Number	:	1821797960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR STANDRIDGE KAYE

Provider Business Mailing Address
First Line	:	652 RUSSELL DR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-6358
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8135 SARATOGA WAY UNIT 200
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-4590
Country	:	US
Telephone Number	:	916-933-1090
Fax Number	:

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

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	02/27/2023

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