Provider Demographics
NPI:1922107309
Name:MILANESE, KRISTINA (PT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MILANESE
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 1:9563 LAGUNA SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8204
Mailing Address - Country:US
Mailing Address - Phone:916-691-9822
Mailing Address - Fax:916-691-9448
Practice Address - Street 1:9563 LAGUNA SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8204
Practice Address - Country:US
Practice Address - Phone:916-691-9822
Practice Address - Fax:916-691-9448
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT323061OtherPTAN