Active NPI
Kristine Davenport, PT
- Physical Therapist
- Orangevale, CA
National Provider Identifier
1780103622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18582
- Practice address
- 6437 Pecan Ave.
Orangevale, CA 95662-4123 - Phone
- (916) 768-8265
- Fax
- (916) 987-7104
- NPI assigned
- Sep 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 18582 | CA | Primary |
Addresses
Primary practice location
6437 Pecan Ave.
Orangevale, CA 95662-4123
Mailing address
6437 Pecan Ave
Orangevale, CA 95662-4123
Phone (916) 768-8265
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 |
|---|---|---|---|
| 18582 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780103622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6437 PECAN AVE",
"city": "ORANGEVALE",
"state": "CA",
"postal_code": "956624123",
"telephone_number": "916-768-8265",
"fax_number": "916-987-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6437 PECAN AVE.",
"city": "ORANGEVALE",
"state": "CA",
"postal_code": "956624123",
"telephone_number": "916-768-8265",
"fax_number": "916-987-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "KRISTINE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "18582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orangevale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.