Provider Demographics
NPI:1619122454
Name:CHRISSAKIS, HARRY
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:
Last Name:CHRISSAKIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 832
Mailing Address - Street 2:
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0832
Mailing Address - Country:US
Mailing Address - Phone:530-692-0420
Mailing Address - Fax:530-692-2656
Practice Address - Street 1:13376 RUE MONTAIGNE
Practice Address - Street 2:
Practice Address - City:OREGON HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95962
Practice Address - Country:US
Practice Address - Phone:530-692-0420
Practice Address - Fax:530-692-2656
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist