Provider Demographics
NPI:1629666250
Name:NEUNER, KRISTINA E
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:E
Last Name:NEUNER
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 1:731 GARNER LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4806
Mailing Address - Country:US
Mailing Address - Phone:209-518-2878
Mailing Address - Fax:
Practice Address - Street 1:5820 OWENS DR BLDG E2ND
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3900
Practice Address - Country:US
Practice Address - Phone:877-457-4772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37031167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician