Provider Demographics
NPI:1588681043
Name:KAW, CRISTETA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTETA
Middle Name:
Last Name:KAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 JEFFERSON ST
Mailing Address - Street 2:#196
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3436
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-252-9325
Practice Address - Street 1:115 ODDSTAD DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2520
Practice Address - Country:US
Practice Address - Phone:707-255-8825
Practice Address - Fax:707-252-9325
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA346492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry