Provider Demographics
NPI:1578832903
Name:KRENTZ, DOROTHY ANN (CADCA)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:ANN
Last Name:KRENTZ
Suffix:
Gender:F
Credentials:CADCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 SHADY WILLOW LN UNIT 23D
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-3729
Mailing Address - Country:US
Mailing Address - Phone:925-305-0740
Mailing Address - Fax:
Practice Address - Street 1:2400 SHADY WILLOW LN UNIT 23D
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-3729
Practice Address - Country:US
Practice Address - Phone:925-305-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI4620812101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)