Thalassa Amber Kettering

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT6703 Issued in CA

Practice address

2400 W Acacia Ave
Hemet, CA 92545-3743

Phone

(951) 766-5116

NPI assigned

Aug 12, 2022

Last updated

Aug 12, 2022By the provider in NPPES

Sex

Female

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)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Interface Rehab, Inc.

  • Physical Disabilities Residential Treatment Facility
  • Placentia, CA
  • NPI 1306960851
  NPD

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1164150546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 FLOWER ST",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922237172",
            "telephone_number": "951-766-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W ACACIA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925453743",
            "telephone_number": "951-766-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERING",
        "first_name": "THALASSA",
        "middle_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT6703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Caroline Keith, M.D.
• Crystal Marie Keller, AMFT
• Marilou Keller, CNS
• Cleo Kelly
• Elaja'a Kelly
• Kevin Michael Brown Chiropractic Corp
• Mohamed Khalaf
• Kassandra Khandjian
• Mohammad R Khayali, M.D.
• Balraj Singh Khehra, P.T.

• Physical Therapy Assistant in Hemet, CA
• Providers in Hemet, 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 Aug 12, 2022; 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.