Provider Demographics
NPI:1598397762
Name:MANLANGIT, KIMBERLY ANN (DPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY ANN
Middle Name:
Last Name:MANLANGIT
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 1:9672 DARLEY WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-4032
Mailing Address - Country:US
Mailing Address - Phone:916-266-3906
Mailing Address - Fax:
Practice Address - Street 1:1600 TRIBUTE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4400
Practice Address - Country:US
Practice Address - Phone:916-905-6378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2980862251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA298086OtherPHYSICAL THERAPY BOARD OF CA