Provider Demographics
NPI:1811274079
Name:FROHLICH, CHRISTINA CHANDRA (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CHANDRA
Last Name:FROHLICH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 S CHINA LAKE BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-4685
Mailing Address - Country:US
Mailing Address - Phone:909-362-1196
Mailing Address - Fax:
Practice Address - Street 1:212 ELKS POINT RD UNIT 332
Practice Address - Street 2:
Practice Address - City:ZEPHYR COVE
Practice Address - State:NV
Practice Address - Zip Code:89448-8016
Practice Address - Country:US
Practice Address - Phone:530-541-7133
Practice Address - Fax:530-725-4500
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4448225100000X
CA38239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist