Provider Demographics
NPI:1285471169
Name:KEHR, MCKENZIE DARLENE (DPT)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:DARLENE
Last Name:KEHR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 GROTON ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5627
Mailing Address - Country:US
Mailing Address - Phone:847-224-4852
Mailing Address - Fax:
Practice Address - Street 1:10300 CAMPUS POINT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1504
Practice Address - Country:US
Practice Address - Phone:858-227-9707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist