Individual
LISA CRISTOL HENRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
20823 STEVENS CREEK BLVD, SUITE #200, CUPERTINO, CA 95014-2108
(408) 252-6076
(408) 252-1159
Mailing address
20823 STEVENS CREEK BLVD, SUITE #200, CUPERTINO, CA 95014-2108
(408) 252-6076
(408) 252-1159
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT34928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT34928
CALIFORNIA STATE LICENSE NUMBER
CA
Enumeration date
10/31/2008
Last updated
07/02/2012
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