Individual
MRS. SANDY LYNN KIENTZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CD(DONA)
Contact information
Practice address
17090 CHANNEL ST, SAN LORENZO, CA 94580-2218
(510) 294-9926
Mailing address
17090 CHANNEL ST, SAN LORENZO, CA 94580-2218
(510) 294-9926
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
10452
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1217363
DONA
—
Enumeration date
04/06/2017
Last updated
04/06/2017
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