Provider Demographics
NPI:1750750907
Name:HUNT, KRISTIN CORINNE
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:CORINNE
Last Name:HUNT
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 1:6445 BELGROVE WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6307
Mailing Address - Country:US
Mailing Address - Phone:775-815-1456
Mailing Address - Fax:530-295-8235
Practice Address - Street 1:344 PLACERVILLE DR
Practice Address - Street 2:SUITE 17
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-3920
Practice Address - Country:US
Practice Address - Phone:530-295-8206
Practice Address - Fax:530-295-8235
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARADT-I/RS6849101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)