Provider Demographics
NPI:1235938531
Name:QUITOLA, KRISTEN C (PT, DPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:C
Last Name:QUITOLA
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41768 TRENOUTH ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4125
Mailing Address - Country:US
Mailing Address - Phone:341-235-1938
Mailing Address - Fax:
Practice Address - Street 1:2483 MIDDLEFIELD WAY, SUITE 180
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043
Practice Address - Country:US
Practice Address - Phone:650-967-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist