Provider Demographics
NPI:1295759991
Name:SCHMITZ, CRAIG DARRYL (PT)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:DARRYL
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 ARABIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4774
Mailing Address - Country:US
Mailing Address - Phone:831-439-0710
Mailing Address - Fax:
Practice Address - Street 1:680 E ROMIE LN
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4206
Practice Address - Country:US
Practice Address - Phone:831-758-5338
Practice Address - Fax:831-758-5385
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT11697Medicare ID - Type UnspecifiedPT LICENSE #