Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kyle Fardanesh

Individual provider Physical Therapy Assistant · NPI 1043762305

Kyle Fardanesh is a Physical Therapy Assistant in Elk Grove, California. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

9105 Four Seasons Dr
Elk Grove, CA 95624-1288
Phone: (916) 792-1889
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X

Record details

NPI number1043762305
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 2, 2016
Last updated in NPPESNovember 2, 2016

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