Organization
SIERRA PEDIATRIC THERAPY CLINIC
Active
Organization
SIERRA PEDIATRIC THERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTINE N. CORN PT, MSPT, DPT (OWNER)
(916) 791-2747
Entity
Organization
Contact information
Practice address
720 SUNRISE AVE, SUITE D110, ROSEVILLE, CA 95661-4516
(916) 791-2747
(916) 791-2189
Mailing address
720 SUNRISE AVE, SUITE D110, ROSEVILLE, CA 95661-4516
(916) 791-2747
(916) 791-2189
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT684
CA
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
OT7936
CA
225XP0200X
Pediatric Occupational Therapist
OT7936
CA
Other
Enumeration date
08/26/2014
Last updated
11/13/2014
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