Provider Demographics
NPI:1295207017
Name:CRIADO, KITZIA
Entity type:Individual
Prefix:
First Name:KITZIA
Middle Name:
Last Name:CRIADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 WINDBRIDGE DR APT 130
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5216
Mailing Address - Country:US
Mailing Address - Phone:831-821-0571
Mailing Address - Fax:
Practice Address - Street 1:7525 WINDBRIDGE DR APT 130
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5216
Practice Address - Country:US
Practice Address - Phone:831-821-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25227227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered