Basic Information
| Provider Information | |||||||||
| NPI: | 1942218060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRINSKY | ||||||||
| FirstName: | ALISA | ||||||||
| MiddleName: | LORI | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, CTRS, RTC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20891 COMANCHE TRL | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950338874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083531700 | ||||||||
| FaxNumber: | 4083531700 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 MIRANDA AVE | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504935000 | ||||||||
| FaxNumber: | 6508523455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225800000X | 2795-T (CERTIFICATE) | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Recreation Therapist |
No ID Information.