Active NPI
Kristin L Walstad, PT
- Physical Therapist
- Auburn, CA
National Provider Identifier
1154519189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25759
- Practice address
- 11930 Heritage Oak PL
Suite 9
Auburn, CA 95603-2458 - Phone
- (530) 887-8785
- Fax
- (530) 887-8112
- NPI assigned
- Oct 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT25759 | CA | Primary |
Addresses
Primary practice location
11930 Heritage Oak PL
Suite 9
Auburn, CA 95603-2458
Mailing address
10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT25759 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382572800000",
"number": "1154519189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD",
"address_2": "SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "800-470-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11930 HERITAGE OAK PL",
"address_2": "SUITE 9",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032458",
"telephone_number": "530-887-8785",
"fax_number": "530-887-8112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSTAD",
"first_name": "KRISTIN",
"middle_name": "L",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-03",
"last_updated": "2013-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT25759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.