Provider Demographics
NPI:1912941816
Name:KLINE, RAYNA G (PT)
Entity Type:Individual
Prefix:MISS
First Name:RAYNA
Middle Name:G
Last Name:KLINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 EUREKA WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-247-1280
Mailing Address - Fax:530-247-0310
Practice Address - Street 1:1225 EUREKA WAY
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-247-1280
Practice Address - Fax:530-247-0310
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10192174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT101922Medicare PIN
CAP05913Medicare UPIN