Individual provider Active NPI

Kimberly Kathleen Aboosh, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1114948718
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21888 Issued in CA
Practice address
20 Rockmont Cir
Sacramento, CA 95835-1503
Phone
(916) 416-2627
Fax
(916) 419-8650
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 21888 CA Primary

Addresses

Primary practice location

20 Rockmont Cir
Sacramento, CA 95835-1503

Mailing address

20 Rockmont Cir
Sacramento, CA 95835-1503
Phone (916) 416-2627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 21888CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1114948718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ROCKMONT CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351503",
            "telephone_number": "916-416-2627",
            "fax_number": "916-419-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ROCKMONT CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351503",
            "telephone_number": "916-416-2627",
            "fax_number": "916-419-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOOSH",
        "first_name": "KIMBERLY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 21888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.