Basic Information
| Provider Information | |||||||||
| NPI: | 1063799229 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | TIMBERS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6102 AVENIDA ENCINAS | ||||||||
| Address2: | STE E | ||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920111005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606349750 | ||||||||
| FaxNumber: | 7606349752 | ||||||||
| Practice Location | |||||||||
| Address1: | 6221 METROPOLITAN ST | ||||||||
| Address2: | #101 | ||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920093096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607075080 | ||||||||
| FaxNumber: | 7607075085 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2011 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 38379 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.