Provider Demographics
NPI:1518124148
Name:KENT, CHRISTINE A
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:KENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 CLAY STREET 5TH FLOOR
Mailing Address - Street 2:SUITE 513
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1932
Mailing Address - Country:US
Mailing Address - Phone:415-867-3337
Mailing Address - Fax:
Practice Address - Street 1:2340 CLAY STREET 5TH FLOOR
Practice Address - Street 2:SUITE 513
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1932
Practice Address - Country:US
Practice Address - Phone:415-867-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6681225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist