Provider Demographics
NPI:1205382611
Name:KRET, CECILIA RAMOS (PT)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:RAMOS
Last Name:KRET
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 1:839 VIA JUAN PABLO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN BAUTISTA
Mailing Address - State:CA
Mailing Address - Zip Code:95045-9324
Mailing Address - Country:US
Mailing Address - Phone:831-207-3520
Mailing Address - Fax:
Practice Address - Street 1:839 VIA JUAN PABLO
Practice Address - Street 2:
Practice Address - City:SAN JUAN BAUTISTA
Practice Address - State:CA
Practice Address - Zip Code:95045-9324
Practice Address - Country:US
Practice Address - Phone:831-207-3520
Practice Address - Fax:831-623-9221
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-27
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist