Healthcare Provider Details

I. General information

NPI: 1629149471
Provider Name (Legal Business Name): HEALTHY LIFE REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 FILLMORE ST SUITE 216
SAN FRANCISCO CA
94115-5236
US

IV. Provider business mailing address

1426 FILLMORE ST SUITE 216
SAN FRANCISCO CA
94115-5236
US

V. Phone/Fax

Practice location:
  • Phone: 415-614-0000
  • Fax: 415-614-2024
Mailing address:
  • Phone: 415-614-0000
  • Fax: 415-614-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MARINA KRUPNIK
Title or Position: CEO
Credential:
Phone: 415-614-0000