Provider Demographics
NPI:1346668241
Name:WATFORD, KRISTINE DIONISIO (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:DIONISIO
Last Name:WATFORD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1604 BLOSSOM HILL ROAD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-6350
Mailing Address - Country:US
Mailing Address - Phone:408-528-8833
Mailing Address - Fax:
Practice Address - Street 1:1604 BLOSSOM HILL ROAD
Practice Address - Street 2:SUITE 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-6350
Practice Address - Country:US
Practice Address - Phone:408-528-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA153834207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine