Provider Demographics
NPI:1871131656
Name:LENZI, VERONIKA DORINDA (CMLDT, CMT)
Entity type:Individual
Prefix:
First Name:VERONIKA
Middle Name:DORINDA
Last Name:LENZI
Suffix:
Gender:F
Credentials:CMLDT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 WINTERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-4067
Mailing Address - Country:US
Mailing Address - Phone:707-254-5260
Mailing Address - Fax:
Practice Address - Street 1:204 G ST STE 208
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-4262
Practice Address - Country:US
Practice Address - Phone:707-254-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20906225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist