Provider Demographics
NPI:1568008274
Name:CHRISNEY, SYLVIA (CMT)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:CHRISNEY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:95524-0145
Mailing Address - Country:US
Mailing Address - Phone:510-495-4171
Mailing Address - Fax:
Practice Address - Street 1:145 G ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6694
Practice Address - Country:US
Practice Address - Phone:707-599-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist