Individual provider Active NPI

Kelsey Quiambao, PT, DPT

  • Physical Therapist
  • Fullerton, CA
National Provider Identifier
1801601331
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT307294 Issued in CA
Practice address
1027 N Harbor Blvd Ste B
Fullerton, CA 92832-1362
Phone
(714) 870-8478
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT307294 CA Primary

Addresses

Primary practice location

1027 N Harbor Blvd Ste B
Fullerton, CA 92832-1362

Mailing address

1150 N Voyager LN
Anaheim, CA 92801-1735
Phone (714) 757-7439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227002297 CA Practitioner - Physical Therapist in Private Practice 5698295194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Total Body Physical Therapy PCGroup PAC ID 3678842663, 12 clinicians
Reekstin Enterprises Inc.Group PAC ID 3678603586, 13 clinicians

Practice addresses (Care Compare)

120 S Chaparral CT
Suite 150
Anaheim, CA 92808-2278
Phone (714) 998-9580

41278 Margarita Rd
Suite 102
Temecula, CA 92591-5579
Phone (951) 587-8105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT307294CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reekstin Enterprises Inc. Physical Therapist CurrentSince Feb 14, 2025 Accepting new patients
Core Total Body Physical Therapy, P.C. Physical Therapist CurrentSince Feb 14, 2025 Accepting new patients

Locations

120 S Chaparral Ct
Ste 150
Anaheim, CA 92808
Phone (714) 998-9580

1027 N Harbor Blvd
Ste B
Fullerton, CA 92832
Phone (714) 870-8478

1026 E Chapman Ave
Ste B
Orange, CA 92866
Phone (714) 538-1952

41278 Margarita Rd
Ste 102
Temecula, CA 92591
Phone (951) 587-8105

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1801601331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N VOYAGER LN",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011735",
            "telephone_number": "714-757-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 N HARBOR BLVD STE B",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321362",
            "telephone_number": "714-870-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIAMBAO",
        "first_name": "KELSEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT307294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.