Provider Demographics
NPI:1356475966
Name:BRINGINO, KELLY (DPT)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:BRINGINO
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 1:805 VETERANS BLVD
Mailing Address - Street 2:STE. 303
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1734
Mailing Address - Country:US
Mailing Address - Phone:650-306-1100
Mailing Address - Fax:650-306-1104
Practice Address - Street 1:805 VETERANS BLVD
Practice Address - Street 2:STE. 303
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1734
Practice Address - Country:US
Practice Address - Phone:650-306-1100
Practice Address - Fax:650-306-1104
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist