Sierra Pediatric Therapy Clinic

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT684 Issued in CA

Legal business name

SIERRA PEDIATRIC THERAPY CLINIC

Practice address

720 Sunrise Ave
Suite D110
Roseville, CA 95661-4516

Phone

(916) 791-2747

Fax

(916) 791-2189

NPI assigned

Aug 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kristine N. Corn, PT, MSPT, DPTNPI 1275671398

Title

Owner

Phone

(916) 791-2747

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristine N Corn, P.T., M.S.P.T.D.P.T.

  • Physical Medicine & Rehabilitation Physician
  • Granite Bay, CA
  • NPI 1275671398
  NPD (past) Authorized official

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1639579758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE",
            "address_2": "SUITE D110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614516",
            "telephone_number": "916-791-2747",
            "fax_number": "916-791-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE",
            "address_2": "SUITE D110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614516",
            "telephone_number": "916-791-2747",
            "fax_number": "916-791-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA PEDIATRIC THERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "CORN",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-791-2747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, MSPT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT684",
            "primary": true
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "CA",
            "license": "OT7936",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT7936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Mental Wellness Group
• Sierra Mental Wellness Group
• Sierra Newt LLC.
• Sierra Oncology Rehabilitation
• Sierra Pacific Surgical, Inc.
• Sierra Pregnancy & Health
• Sierra Rehabilitation Medical Associates Inc
• Sierra Rose Family Physicians Medical Group
• Sierra West Rcfe
• Alexandra Sierra, MA

• Pediatric Physical Therapist in Roseville, CA
• Providers in Roseville, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.