Provider Demographics
NPI:1174858682
Name:HATTEN, KRISTIN (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HATTEN
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 1:1405 VAN NESS AVE
Mailing Address - Street 2:204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 S AMPHLETT BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2517
Practice Address - Country:US
Practice Address - Phone:415-346-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA352192251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics