Provider Demographics
NPI:1063799229
Name:ANDERSON, KRISTIN TIMBERS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:TIMBERS
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6102 AVENIDA ENCINAS
Mailing Address - Street 2:STE E
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1005
Mailing Address - Country:US
Mailing Address - Phone:760-634-9750
Mailing Address - Fax:760-634-9752
Practice Address - Street 1:6221 METROPOLITAN ST
Practice Address - Street 2:#101
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-3096
Practice Address - Country:US
Practice Address - Phone:760-707-5080
Practice Address - Fax:760-707-5085
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist