Provider Demographics
NPI:1891895744
Name:ARNETT, KIMBERLY A (PTA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:ARNETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10623 BOULDER ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2645
Mailing Address - Country:US
Mailing Address - Phone:530-274-2320
Mailing Address - Fax:530-274-1568
Practice Address - Street 1:300 SIERRA COLLEGE DR STE 165
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5083
Practice Address - Country:US
Practice Address - Phone:530-274-2320
Practice Address - Fax:530-274-1568
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT2544225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant