Provider Demographics
NPI:1407307184
Name:FRANCISCO, KRISTA HAUNANI (ATC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:HAUNANI
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 S TREMONT ST
Mailing Address - Street 2:APT 20
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054
Mailing Address - Country:US
Mailing Address - Phone:509-952-0896
Mailing Address - Fax:
Practice Address - Street 1:2030 S TREMONT ST
Practice Address - Street 2:APT 20
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6537
Practice Address - Country:US
Practice Address - Phone:509-952-0896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000002375OtherBOC CERTIFICATION NUMBER