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Individual

SCARLETT MARION KROENCKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1712 PICASSO AVE, SUITE C, DAVIS, CA 95618-0546
(530) 753-6280
(530) 753-6281
Mailing address
1712 PICASSO AVE, SUITE C, DAVIS, CA 95618-0546
(530) 753-6280
(530) 753-6281

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3832
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3832
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E38320
CA
01
P00119813
RAIL ROAD MEDICARE
CA
Enumeration date
05/11/2006
Last updated
07/15/2009
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