Provider Demographics
NPI:1144241084
Name:KESTLER, ROBERTA P (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:P
Last Name:KESTLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 SUMMERTREE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-1292
Mailing Address - Country:US
Mailing Address - Phone:707-542-6224
Mailing Address - Fax:
Practice Address - Street 1:629 SUMMERTREE LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1292
Practice Address - Country:US
Practice Address - Phone:707-542-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor