Provider Demographics
NPI:1356099865
Name:ABEJO, KRISTINE LLOSA
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LLOSA
Last Name:ABEJO
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 1:3064 CEANOTHUS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9175
Mailing Address - Country:US
Mailing Address - Phone:530-828-5789
Mailing Address - Fax:
Practice Address - Street 1:3064 CEANOTHUS AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-9175
Practice Address - Country:US
Practice Address - Phone:530-828-5789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility