Provider Demographics
NPI:1326706375
Name:KITTRELL, CHELSEA (DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KITTRELL
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 1:1152 E JASMINE SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-6405
Mailing Address - Country:US
Mailing Address - Phone:559-359-9707
Mailing Address - Fax:
Practice Address - Street 1:7525 N CEDAR AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2689
Practice Address - Country:US
Practice Address - Phone:559-257-3991
Practice Address - Fax:559-257-3992
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3007162251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic