Provider Demographics
NPI:1649143918
Name:TELANDER, KERI (PT)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:TELANDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 RIVER PARK DR STE 404
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4524
Mailing Address - Country:US
Mailing Address - Phone:916-567-1244
Mailing Address - Fax:
Practice Address - Street 1:1425 RIVER PARK DR STE 404
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4524
Practice Address - Country:US
Practice Address - Phone:916-567-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist