Provider Demographics
NPI:1467629980
Name:MACARAEG, KRISTINE JOY (IDHS, NREMT)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:JOY
Last Name:MACARAEG
Suffix:
Gender:F
Credentials:IDHS, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EAGLE RD BLDG 50-2
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5101
Mailing Address - Country:US
Mailing Address - Phone:727-403-6599
Mailing Address - Fax:
Practice Address - Street 1:1 EAGLE RD BLDG 42
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5101
Practice Address - Country:US
Practice Address - Phone:727-403-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians