Kenneth R Reisenauer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

110910 Issued in CA

Practice address

901 Sneath LN
Suite 105
San Bruno, CA 94066-2400

Phone

(650) 952-8450

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• Morello Family Chiropractic, Inc

  • Chiropractor
  • South San Francisco, CA
  • NPI 1710206040
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598831893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SNEATH LN",
            "address_2": "SUITE 105",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662400",
            "telephone_number": "650-952-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SNEATH LN",
            "address_2": "SUITE 105",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662400",
            "telephone_number": "650-952-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISENAUER",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "110910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackeline Rebuelta
• Haylie Reese
• Tyra Reeves
• Felicia Reich
• Rebecca Reinhardt Mullins
• Holly Anne Rekow, HOLLY REKOW
• Harold Relosimon
• Diana Renteria
• David Thomas Rew
• Maria Reyes Fabregat

• Chiropractor in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Chiropractor in California

• 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.