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General NPI Number Information
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NPI Number | 1689991572
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTEGRAL HEALING INC.
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 182 FARMERS LANE #203
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City | SANTA ROSA
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State | CA
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Zip | 95405
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Country | US
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Telephone | 707-578-0961
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Fax | 707-578-0961
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Provider Business Mailing Address
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Address Line | 182 FARMERS LANE #203
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City | SANTA ROSA
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State | CA
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Zip | 95405
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Country | US
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Telephone | 707-578-0961
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Fax | 707-578-0961
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. RENEE G. VALENTINO
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Credential | P.T.
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Telephone | 707-578-0961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | PT17723
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT17723
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License Number State | CA
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