Provider Demographics
NPI:1669596425
Name:ARNESON, KRIS (PT)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:ARNESON
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 1:108 PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1622
Mailing Address - Country:US
Mailing Address - Phone:415-730-0092
Mailing Address - Fax:
Practice Address - Street 1:2700 GRANT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2266
Practice Address - Country:US
Practice Address - Phone:925-674-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist