Provider Demographics
NPI:1992843478
Name:KRENTZMAN, RACHEL RANDI (RPT,E-RYT, CPYI)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:RANDI
Last Name:KRENTZMAN
Suffix:
Gender:F
Credentials:RPT,E-RYT, CPYI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4081 OHIO ST APT 8
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2651
Mailing Address - Country:US
Mailing Address - Phone:619-261-6049
Mailing Address - Fax:858-454-9305
Practice Address - Street 1:4081 OHIO ST APT 8
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-2651
Practice Address - Country:US
Practice Address - Phone:619-261-6049
Practice Address - Fax:858-454-9305
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist