Provider Demographics
NPI:1053836932
Name:RESARI, KRISTINE (P T)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:RESARI
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CALLOWAY DR STE 603
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2514
Mailing Address - Country:US
Mailing Address - Phone:661-377-1700
Mailing Address - Fax:
Practice Address - Street 1:13019 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-9570
Practice Address - Country:US
Practice Address - Phone:661-377-1700
Practice Address - Fax:661-616-9199
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT293278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist