Provider Demographics
NPI:1659826493
Name:KIMBER, BRENDON (PT)
Entity type:Individual
Prefix:
First Name:BRENDON
Middle Name:
Last Name:KIMBER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0641
Mailing Address - Country:US
Mailing Address - Phone:661-328-0650
Mailing Address - Fax:805-788-0845
Practice Address - Street 1:2601 OSWELL ST STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3101
Practice Address - Country:US
Practice Address - Phone:661-871-5908
Practice Address - Fax:661-324-0830
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist