Provider Demographics
NPI:1386844017
Name:PREFERRED HEALTHCARE REGISTRY
Entity Type:Organization
Organization Name:PREFERRED HEALTHCARE REGISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHREVE
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:415-823-4641
Mailing Address - Street 1:1738 SPRUCE ST
Mailing Address - Street 2:APT. C
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1758
Mailing Address - Country:US
Mailing Address - Phone:415-823-4641
Mailing Address - Fax:
Practice Address - Street 1:4655 RUFFNER ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2275
Practice Address - Country:US
Practice Address - Phone:800-787-6787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1891282E00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282E00000XHospitalsLong Term Care Hospital