Provider Demographics
NPI:1750842266
Name:PALITZ, CHRISTINE ALANA
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALANA
Last Name:PALITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 JACKSON ST STE 8
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1556
Mailing Address - Country:US
Mailing Address - Phone:510-516-0322
Mailing Address - Fax:
Practice Address - Street 1:384 JACKSON ST STE 8
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1556
Practice Address - Country:US
Practice Address - Phone:510-516-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist