Provider Demographics
NPI:1962967307
Name:SCHULTE, KRISTINE (PT)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:SCHULTE
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 1:13316 SUNSHINE PATH
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4702
Mailing Address - Country:US
Mailing Address - Phone:408-510-1979
Mailing Address - Fax:
Practice Address - Street 1:3884 NOBEL DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5700
Practice Address - Country:US
Practice Address - Phone:858-625-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist