Healthcare Provider Details

I. General information

NPI: 1942218060
Provider Name (Legal Business Name): ALISA LORI KRINSKY MS, CTRS, RTC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

20891 COMANCHE TRL
LOS GATOS CA
95033-8874
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-852-3455
Mailing address:
  • Phone: 408-353-1700
  • Fax: 408-353-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number2795-T (CERTIFICATE)
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: