Provider Demographics
NPI:1457457137
Name:SHEVLIN, KRIS (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRIS
Middle Name:
Last Name:SHEVLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 J ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3941
Mailing Address - Country:US
Mailing Address - Phone:916-457-7171
Mailing Address - Fax:916-457-7414
Practice Address - Street 1:5207 J ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3941
Practice Address - Country:US
Practice Address - Phone:916-457-7171
Practice Address - Fax:916-457-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist