Provider Demographics
NPI:1477442549
Name:KESINGTON, ANNA JANE (LMT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:JANE
Last Name:KESINGTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:PONOMARENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2120 1ST AVE APT 35
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2120 1ST AVE APT 35
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2044
Practice Address - Country:US
Practice Address - Phone:760-315-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99566225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist