Provider Demographics
NPI:1326341298
Name:TETZ, CHRISTINA (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TETZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24226 PAULSON DR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4872
Mailing Address - Country:US
Mailing Address - Phone:707-815-9088
Mailing Address - Fax:
Practice Address - Street 1:24226 PAULSON DR
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4872
Practice Address - Country:US
Practice Address - Phone:707-815-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 37217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist