Provider Demographics
NPI:1609339191
Name:TREFZGER, ARTHUR THEODORE (CMP)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:THEODORE
Last Name:TREFZGER
Suffix:
Gender:M
Credentials:CMP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:TREFZGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10546 COLOMA RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2325
Mailing Address - Country:US
Mailing Address - Phone:916-621-9379
Mailing Address - Fax:
Practice Address - Street 1:8421 AUBURN BLVD STE 160
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-0384
Practice Address - Country:US
Practice Address - Phone:916-304-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist