Provider Demographics
NPI:1124554845
Name:KRALE, RENEE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:KRALE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:SCHEMBRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3627 63RD ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1932
Mailing Address - Country:US
Mailing Address - Phone:415-309-6774
Mailing Address - Fax:
Practice Address - Street 1:3627 63RD ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1932
Practice Address - Country:US
Practice Address - Phone:415-309-6774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA3894224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant