Healthcare Provider Details

I. General information

NPI: 1417967860
Provider Name (Legal Business Name): VIRGINIA A KRAPF RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8978 BAINBRIDGE PL
STOCKTON CA
95209-4807
US

IV. Provider business mailing address

8978 BAINBRIDGE PL
STOCKTON CA
95209-4807
US

V. Phone/Fax

Practice location:
  • Phone: 209-474-6848
  • Fax: 209-474-1565
Mailing address:
  • Phone: 209-474-6848
  • Fax: 209-474-1565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRCP4858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: