Provider Demographics
NPI:1265767388
Name:KRENDL, RADHA VIANA (RN)
Entity type:Individual
Prefix:
First Name:RADHA
Middle Name:VIANA
Last Name:KRENDL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RADHA
Other - Middle Name:VIANA
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-795-3619
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:1119 PACIFIC AVE
Practice Address - Street 2:STE 200
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-7503
Practice Address - Country:US
Practice Address - Phone:831-460-3100
Practice Address - Fax:831-425-0106
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA755884163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse