Provider Demographics
NPI:1699018499
Name:CHRISTIANSEN, KATERINA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:NICOLE
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CHRISTIANSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3160 FOLSOM BLVD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5267
Mailing Address - Country:US
Mailing Address - Phone:916-734-7777
Mailing Address - Fax:
Practice Address - Street 1:3160 FOLSOM BLVD STE 2500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5267
Practice Address - Country:US
Practice Address - Phone:916-734-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133297207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine