Provider Demographics
NPI:1457056350
Name:LENTZ, SAVANNAH LYNN
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LYNN
Last Name:LENTZ
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 1:720 W GRAND AVE UNIT 1404
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-2577
Mailing Address - Country:US
Mailing Address - Phone:563-203-0654
Mailing Address - Fax:
Practice Address - Street 1:16601 NIGHT HAWK LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-4457
Practice Address - Country:US
Practice Address - Phone:858-487-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer