Provider Demographics
NPI:1073922977
Name:THOMPSON, KERI (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LIGHTHOUSE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1423
Mailing Address - Country:US
Mailing Address - Phone:831-375-5909
Mailing Address - Fax:831-375-7259
Practice Address - Street 1:500 LIGHTHOUSE AVE
Practice Address - Street 2:STE B
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1423
Practice Address - Country:US
Practice Address - Phone:831-375-5909
Practice Address - Fax:831-375-7259
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist