Provider Demographics
NPI:1568143519
Name:BERTSCH, KRISTINE (DIPL, AC , LMT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:BERTSCH
Suffix:
Gender:F
Credentials:DIPL, AC , LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 ARCHETTO DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5438
Mailing Address - Country:US
Mailing Address - Phone:916-220-5747
Mailing Address - Fax:
Practice Address - Street 1:5000 WINDPLAY DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9365
Practice Address - Country:US
Practice Address - Phone:916-245-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist