KIMBERLY LARUE KWAN SHACKELFORD (NPI# 1760733356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760733356 |
| Entity Type | Individual |
| Full Name | KIMBERLY LARUE KWAN SHACKELFORD |
| Other Name | KIMBERLY LARUE KWAN ASATO |
| Credential | DPT |
| Practice Address |
3601 Marconi Ave Sacramento CA 95821-5309 |
| Mailing Address |
3171 Rancho Silva Dr Sacramento CA 95833-1132 |
| Practice Telephone | 9164811300 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2015-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 1221081 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225100000X | Physical Therapist | 40045 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043877749 | Kimberly M Shackelford | Dietitian, Registered | 503 N 21st St, Camp Hill, PA 17011-2288 | 2019-05-29 |
| 1740770544 | Kimberly Shackelford | Counselor | 200 Casentini St, Salinas, CA 93907-2299 | 2018-05-16 |
| Street Address |
3601 MARCONI AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-5309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063513042 | Trisha Lynn Valdez | Occupational Therapist | 3601 Marconi Ave, Isis Healthcare Services Inc., Sacramento, CA 95821 | 2006-09-25 |
| 1295188555 | Eric Salter | Speech-Language Pathologist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2016-07-21 |
| 1790118677 | Linda Lee Porter | Occupational Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2013-08-15 |
| 1992144661 | Karol Kinzly | Occupational Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2013-06-17 |
| 1083970057 | Jennifer Lubeck Klein | Physical Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2012-04-04 |
| 1457620536 | Patricia Ann Shijo | Physical Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2011-12-20 |
| 1568752046 | Maria Cecilia Africa-feser | Occupational Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2011-04-18 |
| 1861791113 | Mariola A Dumitru | Occupational Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2011-03-24 |
| 1326377854 | Alauhua S West | Physical Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2009-12-11 |
| 1508001165 | Elizabeth Dorothy Brushwyler | Physical Therapist | 3601 Marconi Ave, Sacramento, CA 95821-5309 | 2008-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423864 | Tyler Arndt | Physical Therapist | 425 University Ave Ste 140, Sacramento, CA 95825-6506 | 2020-09-25 |
| 1295342335 | Alma Hernandez | Physical Therapist | 601 Feature Dr, Sacramento, CA 95825-8318 | 2020-09-23 |
| 1386263648 | Joy Han | Physical Therapist | 9683 Dartwell Way, Sacramento, CA 95829-1191 | 2020-04-15 |
| 1366079790 | Jennifer Ruona | Physical Therapist | 720 27th St Apt D, Sacramento, CA 95816-4175 | 2020-03-25 |
| 1639718786 | Jessica Wong | Physical Therapist | 36 Still Beach Ct, Sacramento, CA 95831-5568 | 2020-01-06 |
| 1104472901 | Shana Mcgownd | Physical Therapist | 7667 Folsom Blvd, Sacramento, CA 95826-2618 | 2019-08-16 |
| 1235601071 | Mylinh T Phan | Physical Therapist | 3270 Arena Blvd Ste 415, Sacramento, CA 95834-3001 | 2018-12-18 |
| 1396210712 | Melody Rose Haring | Physical Therapist | 3350 Watt Ave Ste G, Sacramento, CA 95821-3618 | 2018-10-12 |
| 1477036531 | Vidya Jayaprakash | Physical Therapist | 6821 24th St, Sacramento, CA 95822-4037 | 2018-09-13 |
| 1174020366 | Loes Vandenbiggelaar | Physical Therapist | 3350 Watt Ave, Sacramento, CA 95821-3618 | 2018-04-12 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
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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.