Individual provider Active NPI

Kathleen M Kenna, PT, DPT

  • Physical Therapist
  • Twain Harte, CA
National Provider Identifier
1346445996
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21909 Issued in CA
Practice address
22511 Twain Harte Dr
Twain Harte, CA 95383-9628
Phone
(209) 586-4689
Fax
(209) 586-2309
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 21909 CA Primary

Addresses

Primary practice location

22511 Twain Harte Dr
Twain Harte, CA 95383-9628

Mailing address

PO Box 1447
Mi Wuk Village, CA 95346-1447
Phone (209) 586-5325

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

LicenseStateTypeSpecialty
21909CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346445996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "MI WUK VILLAGE",
            "state": "CA",
            "postal_code": "953461447",
            "telephone_number": "209-586-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22511 TWAIN HARTE DR",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839628",
            "telephone_number": "209-586-4689",
            "fax_number": "209-586-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNA",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "21909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twain Harte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.