Provider Demographics
NPI:1225416365
Name:KRISTEN YEE MD PC
Entity Type:Organization
Organization Name:KRISTEN YEE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:707-525-8080
Mailing Address - Street 1:1111 SONOMA AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4813
Mailing Address - Country:US
Mailing Address - Phone:707-525-8080
Mailing Address - Fax:707-579-8820
Practice Address - Street 1:1111 SONOMA AVE STE 112
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4813
Practice Address - Country:US
Practice Address - Phone:707-525-8080
Practice Address - Fax:707-579-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91088284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA472217942OtherTAX ID NUMBER