Provider Demographics
NPI:1477822922
Name:NESS, CHRISTINA ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:NESS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 KAREN WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5318
Mailing Address - Country:US
Mailing Address - Phone:707-228-9156
Mailing Address - Fax:
Practice Address - Street 1:642 KAREN WAY
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-5318
Practice Address - Country:US
Practice Address - Phone:707-228-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist