Provider Demographics
NPI:1982837688
Name:HALE, KIMBERLY MCNEAL (DPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MCNEAL
Last Name:HALE
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 1:7321 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-4127
Mailing Address - Country:US
Mailing Address - Phone:510-526-0694
Mailing Address - Fax:
Practice Address - Street 1:7321 LYNN AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-4127
Practice Address - Country:US
Practice Address - Phone:510-526-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist