KELLIE NIELSEN (NPI# 1548813280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548813280 |
| Entity Type | Individual |
| Full Name | KELLIE NIELSEN |
| Credential | DPT |
| Practice Address |
803 Russell Blvd Davis CA 95616-3426 |
| Mailing Address |
3436 Sackett Ln Winters CA 95694-9687 |
| Practice Telephone | 5303918670 |
| Mailing Telephone | 2065181012 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251N0400X |
Physical Therapist Specialization: Neurology |
296763 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
296763 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHYSICAL THERAPY BOARD OF CALIFORNIA | 296763 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992154777 | Kellie Nielsen | Nurse Practitioner | 600 W Hospital Rd, Brigham City, UT 84302-3006 | 2016-06-13 |
| Street Address |
803 RUSSELL BLVD |
| City | DAVIS |
| State | CA |
| Zip Code | 95616-3426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639675994 | Carissa Stenzel | Speech-Language Pathologist | 803 Russell Blvd, Davis, CA 95616-3426 | 2018-04-04 |
| 1689290538 | Kristine Denise Vucurovich | Occupational Therapist | 803 Russell Blvd, Davis, CA 95616-3426 | 2020-06-16 |
| 1598397200 | Chrisyl Mary Jaison | Specialist/Technologist | 803 Russell Blvd, Davis, CA 95616-3426 | 2020-02-11 |
| 1962963868 | Kimberly A Marrs | Specialist/Technologist | 803 Russell Blvd, Davis, CA 95616-3426 | 2019-03-26 |
| 1619457645 | Annelise Kathryn Haile | Occupational Therapy Assistant | 803 Russell Blvd, Davis, CA 95616-3426 | 2018-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346488871 | Katrin Mattern-baxter | Physical Therapist | 1460 Drew Ave Ste 200, Davis, CA 95618-4856 | 2009-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745233 | Tejal Shah Chokshi | Physical Therapist | 7425 La Mantanza, San Diego, CA 92127-3636 | 2020-09-16 |
| 1487277992 | Katherine Anne Zweier | Physical Therapist | 4646 Van Dyke Ave, San Diego, CA 92116-4842 | 2020-05-19 |
| 1184246621 | Achieving Milestones Pediatric Therapy, Inc | Physical Therapist | 221 E Glenoaks Blvd # 225a, Glendale, CA 91207-2085 | 2020-05-07 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1215585690 | Maggie Christine Ridenhour | Physical Therapist | 1541 Old Bayshore Hwy, Burlingame, CA 94010-1602 | 2019-08-29 |
| 1477100162 | Fasia Ramirez | Physical Therapist | 35510 Schuber Ln, Temecula, CA 92592-8125 | 2019-08-19 |
| 1689229841 | Jaclyn Rymer | Physical Therapist | 1000 S Fremont Ave Bldg 10n10220, Alhambra, CA 91803 | 2019-08-05 |
| 1649836669 | Karin Stohn | Physical Therapist | 100 Mcgivern Way, Santa Cruz, CA 95060-9300 | 2019-05-15 |
| 1376108597 | Karen Dzierski Cruise | Physical Therapist | 10860 Topanga Canyon Blvd, Chatsworth, CA 91311-1350 | 2019-05-02 |
| 1326511064 | Lissett Rojas | Physical Therapist | 855 N Lark Ellen Ave Ste L, West Covina, CA 91791-1099 | 2019-01-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.