Kristopher Ryan Watanabe, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29007 Issued in CA

Practice address

6335 N Fresno St Ste 108
Fresno, CA 93710-5272

Phone

(559) 432-0524

Fax

(559) 449-8646

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Sports and Orthopedic Physical Therapy Clinic IncGroup PAC ID 9436314200, 4 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Sports & Orthopedic Physical Therapy Clinic Inc

  • Physical Therapy Clinic/Center
  • Fresno, CA
  • NPI 1922186956

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• The Summit Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Selma, CA
  • NPI 1073989562

  Physical Therapist

  Medicare reassignment NPD
• Spitzers Physical Therapy and Personal Training Center, Inc.

  • Physical Therapist
  • Clovis, CA
  • NPI 1598853400
  NPD
• Advanced Physical and Occupational Therapy

  • Physical Therapy Clinic/Center
  • Fresno, CA
  • NPI 1518159607

  Physical Therapist

  NPD (past)
• Courtney J Moore, Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Selma, CA
  • NPI 1568432599
  NPD (past)
• Fresno Specialized Spine & Physical Therapy, Inc.

  • Physical Therapist
  • Fresno, CA
  • NPI 1790867430
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1659412062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 N FRESNO ST STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105272",
            "telephone_number": "559-432-0524",
            "fax_number": "559-449-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 N FRESNO ST STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105272",
            "telephone_number": "559-432-0524",
            "fax_number": "559-449-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "KRISTOPHER",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PT29007",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanica Eboni Washington
• Tanya Washington
• Maryse Nagy Wadie Wassef
• Annette Dixie Wassell, NP
• Dana Beth Wasserman, PSY.D.
• Katrina Sally Waters, MD
• Rebecca Waters, MD
• Emily Lindsey Waterston, CTRS
• Elizabeth Watkins
• Jeffrey David Watkins, ACSW

• Physical Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.