Active NPI
Kimberly Christine Ryan
- Physical Therapist
- Los Gatos, CA
National Provider Identifier
1730643040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 42249
- Practice address
- 815 Pollard Rd
Los Gatos, CA 95032-1438 - Phone
- (408) 378-6131
- NPI assigned
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 42249 | CA | Primary |
Addresses
Primary practice location
815 Pollard Rd
Los Gatos, CA 95032-1438
Mailing address
115 Banbury Way
Benicia, CA 94510-1604
Phone (707) 208-2205
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42249 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1730643040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 BANBURY WAY",
"city": "BENICIA",
"state": "CA",
"postal_code": "945101604",
"telephone_number": "707-208-2205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 POLLARD RD",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950321438",
"telephone_number": "408-378-6131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "KIMBERLY",
"middle_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-31",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "42249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.