Individual
KIRSTEN FANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.T.
Contact information
Practice address
3636 N 1ST ST, 162; 135, FRESNO, CA 93726-6800
(559) 221-1107
(559) 221-5004
Mailing address
3636 N 1ST ST, 162; 135, FRESNO, CA 93726-6800
(559) 221-1107
(559) 221-5004
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37243
CA
Other
Enumeration date
10/16/2013
Last updated
10/17/2013
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