Provider Demographics
NPI:1740489475
Name:SNOW, CHRISTINE NGUYEN (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:NGUYEN
Last Name:SNOW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:576 N SUNRISE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2846
Mailing Address - Country:US
Mailing Address - Phone:916-773-3737
Mailing Address - Fax:916-773-3936
Practice Address - Street 1:576 N SUNRISE AVE
Practice Address - Street 2:110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2841
Practice Address - Country:US
Practice Address - Phone:916-773-3937
Practice Address - Fax:916-773-3936
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13273152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist