Provider Demographics
NPI:1174397806
Name:KRENZ, AMANDA JANE (ND)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JANE
Last Name:KRENZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 TORREY CIR APT M205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6699
Mailing Address - Country:US
Mailing Address - Phone:701-426-5144
Mailing Address - Fax:
Practice Address - Street 1:4639 TORREY CIR APT M205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6699
Practice Address - Country:US
Practice Address - Phone:701-426-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1468175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath