Provider Demographics
NPI:1073818084
Name:ALANES, KRISTINA (MPT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:ALANES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6549
Mailing Address - Country:US
Mailing Address - Phone:714-542-1234
Mailing Address - Fax:714-542-1002
Practice Address - Street 1:217 W CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6549
Practice Address - Country:US
Practice Address - Phone:714-542-1234
Practice Address - Fax:714-542-1002
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335592251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics