Provider Demographics
NPI:1184785610
Name:JUINIO, KIRSTEN IRENE (PT)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:IRENE
Last Name:JUINIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KIRSTEN
Other - Middle Name:IRENE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:8839 N CEDAR AVE # 315
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1832
Mailing Address - Country:US
Mailing Address - Phone:559-259-5761
Mailing Address - Fax:
Practice Address - Street 1:7300 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2941
Practice Address - Country:US
Practice Address - Phone:559-448-4234
Practice Address - Fax:559-448-4264
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist