Provider Demographics
NPI:1427316249
Name:SENTO, KELLI (BS, PTA, CSCS)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:
Last Name:SENTO
Suffix:
Gender:F
Credentials:BS, PTA, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 RANCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3241
Mailing Address - Country:US
Mailing Address - Phone:714-642-5300
Mailing Address - Fax:
Practice Address - Street 1:6719 RANCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3241
Practice Address - Country:US
Practice Address - Phone:714-642-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 5169225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant