Provider Demographics
NPI:1700436961
Name:BATES, CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:BATES
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 1:1370 SAN VICENTE RD
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-3327
Mailing Address - Country:US
Mailing Address - Phone:858-518-3114
Mailing Address - Fax:
Practice Address - Street 1:1370 SAN VICENTE RD
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-3327
Practice Address - Country:US
Practice Address - Phone:858-518-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider