Provider Demographics
NPI:1659745032
Name:SURRAGO, CHRISTINE (ND)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:SURRAGO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19748 GRAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3312
Mailing Address - Country:US
Mailing Address - Phone:425-381-1839
Mailing Address - Fax:
Practice Address - Street 1:19748 GRAND VIEW DR
Practice Address - Street 2:
Practice Address - City:TOPANGA
Practice Address - State:CA
Practice Address - Zip Code:90290-3312
Practice Address - Country:US
Practice Address - Phone:425-381-1839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND761175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath