Provider Demographics
NPI:1093036030
Name:PAESE, KRISTIN LEIGH
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEIGH
Last Name:PAESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 FLORAL AVE
Mailing Address - Street 2:30
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9143
Mailing Address - Country:US
Mailing Address - Phone:530-893-4784
Mailing Address - Fax:
Practice Address - Street 1:2550 FLORAL AVE
Practice Address - Street 2:30
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-9143
Practice Address - Country:US
Practice Address - Phone:530-893-4784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health