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

Mrs. Kristin Tyse Shadduck, PT

Individual provider Physical Therapist · NPI 1255348462

Mrs. Kristin Tyse Shadduck, PT is a Physical Therapist in Private Practice in Los Altos, California. Qualified in 1981, 45 years ago. Practices with Shadduck - Physical Therapy Works Inc, a 12-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
45
Licensed in
CA
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

794 Altos Oaks Dr
Los Altos, CA 94024-6013
Phone: (650) 947-9646
Fax: (650) 947-9566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11542 (CA)

Record details

NPI number1255348462
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 1, 2006
Last updated in NPPESMarch 14, 2023
Certification dateMarch 14, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1981 (45 years in practice)
Group practice Shadduck - Physical Therapy Works Inc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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