Provider Demographics
NPI:1891049680
Name:ANDREW, CHRISTINE ANN (CNC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANN
Last Name:ANDREW
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 CERNON ST STE A
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4543
Mailing Address - Country:US
Mailing Address - Phone:707-451-4058
Mailing Address - Fax:
Practice Address - Street 1:348 CERNON ST STE A
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4543
Practice Address - Country:US
Practice Address - Phone:707-451-4058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist