Provider Demographics
NPI:1801347851
Name:CHRISTIANSON, KARI (PT, DPT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 TIDEWAY DR
Mailing Address - Street 2:APT A
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3542
Mailing Address - Country:US
Mailing Address - Phone:612-280-8587
Mailing Address - Fax:
Practice Address - Street 1:321 TIDEWAY DR
Practice Address - Street 2:APT A
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3542
Practice Address - Country:US
Practice Address - Phone:612-280-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist