Krishna Wittman, OTL, MPT, CEAS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26347 Issued in CA

Practice address

4050 Redwood Hwy Ste G
San Rafael, CA 94903-5149

Phone

(415) 479-7100

NPI assigned

Jul 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kris Wittman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1639693013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LOS GAMOS DR STE 140",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 REDWOOD HWY STE G",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035149",
            "telephone_number": "415-479-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTMAN",
        "first_name": "KRISHNA",
        "credential": "OTL, MPT, CEAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "5951",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRIS",
            "last_name": "WITTMAN",
            "credential": "OTL, MPT, CEAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Renee Withrow, L.AC.
• David J. Witt, MD
• Karen Witt
• Hasso Wittboldt-Mueller, N.D.
• Madison Mae Witte, COTA/L
• Kenna Wohlford
• Cordelia Wolf
• Albert Michael Wolfe, PH.D.
• Rachel Wolfe, DPT
• Wayne W Wolfe, M.D

• Physical Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.