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General NPI Number Information
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NPI Number | 1285545400
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Entity Type | Organization
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Legal Business Name | FROZEN IN TIME CRYO THERAPY CENTER
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 31534 RAILROAD CANYON RD STE H
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City | CANYON LAKE
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State | CA
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Zip | 92587-9439
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Country | US
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Telephone | 888-348-2796
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Fax |
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Provider Business Mailing Address
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Address Line | 31534 RAILROAD CANYON RD STE H
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City | CANYON LAKE
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State | CA
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Zip | 92587-9439
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Country | US
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Telephone | 888-348-2796
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTIN JACOBSON-ESTELL
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Credential | BEHAVIOR ANALYST
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Telephone | 888-348-2796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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