Kyle Fardanesh

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

9105 Four Seasons Dr
Elk Grove, CA 95624-1288

Phone

(916) 792-1889

NPI assigned

Nov 2, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1043762305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 FOUR SEASONS DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 FOUR SEASONS DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241288",
            "telephone_number": "916-792-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDANESH",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Fahn
• Xuan Vu Falah, PHARM.D.
• Family Counseling of Elk Grove
• Albert Fang, PHARM.D.
• Alisha Fang
• Nahla Farghalli, MD
• Alexander J Farinha
• Nicole Marek Faro, MD
• Atila Farr
• Katy Farris

• Physical Therapy Assistant in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.