Healthcare Provider Details

I. General information

NPI: 1295567766
Provider Name (Legal Business Name): MONICA KRANTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 S ORCHARD AVE
UKIAH CA
95482-5011
US

IV. Provider business mailing address

PO BOX 2077
UKIAH CA
95482-2077
US

V. Phone/Fax

Practice location:
  • Phone: 707-467-2010
  • Fax:
Mailing address:
  • Phone: 707-467-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number161448
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: