| Kimberly Larue Kwan Shackelford, DPT | |
|
3601 Marconi Ave, Sacramento, CA 95821-5309 | |
| (916) 481-1300 | |
| Not Available |
| Full Name | Kimberly Larue Kwan Shackelford |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 3601 Marconi Ave, Sacramento, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760733356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1221081 (Texas) | Secondary |
| 225100000X | Physical Therapist | 40045 (California) | Primary |
| Provider Name | Laguna Physical Therapy & Hand Rehabilitation |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1912043993 PECOS PAC ID: 6901905280 Enrollment ID: O20070627000490 |
| Provider Name | Capuchino Therapy Group |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1568538064 PECOS PAC ID: 2860554839 Enrollment ID: O20081230000009 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Larue Kwan Shackelford, DPT 3171 Rancho Silva Dr, Sacramento, CA 95833-1132 Ph: () - | Kimberly Larue Kwan Shackelford, DPT 3601 Marconi Ave, Sacramento, CA 95821-5309 Ph: (916) 481-1300 |
Tyler Arndt, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 425 University Ave Ste 140, Sacramento, CA 95825 Phone: 916-927-1333 Fax: 916-927-1586 | |
Mrs. Ingrid S Parry, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3401 Folsom Blvd, Suite B, Sacramento, CA 95816 Phone: 916-455-5524 Fax: 916-455-5584 | |
Mr. Lee Robert Skogan, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 121 Suez Canal Ln, Sacramento, CA 95834 Phone: 360-441-5380 | |
Ms. Carole G Cannon, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1090 Rio Lane, Sacramento, CA 95822 Phone: 916-446-2506 | |
Diane Marie Stinson-roberts, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 5128 Fredericksburg Way, Sacramento, CA 95835 Phone: 916-396-5558 | |
Rachel Leigh Brown, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3501 Mckinley Village Way, Sacramento, CA 95816 Phone: 360-593-2114 | |
Sarah Elizabeth Wittmer, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3240 Arden Way, Sacramento, CA 95825 Phone: 916-599-2519 |