Provider Demographics
NPI:1346819075
Name:EDWARDS, CHRISTINE DIANE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DIANE
Last Name:EDWARDS
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 1:3000 PARKER RD # 20
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-2742
Mailing Address - Country:US
Mailing Address - Phone:510-307-4630
Mailing Address - Fax:510-724-8829
Practice Address - Street 1:3000 PARKER RD # 20
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-2742
Practice Address - Country:US
Practice Address - Phone:510-307-4630
Practice Address - Fax:510-724-8829
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other