Provider Demographics
NPI:1881786390
Name:BRAID, CHRISTINE LYNN SHULTZ (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN SHULTZ
Last Name:BRAID
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LYNN
Other - Last Name:SHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8001 MADISON AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7901
Practice Address - Country:US
Practice Address - Phone:916-536-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5686767OtherCIGNA
CA5706778OtherFIRST HEALTH
CA000810801670OtherPHCS
CA131777OtherHEALTH NET
CA2058499OtherGREAT WEST
CA7281817OtherAETNA
CA2689403OtherUNITED
CA00AX89550Medicaid
CA020A89550OtherBLUE SHIELD
CA20A8955OtherBLUE CROSS
CAMCMG476200OtherWESTERN HEALTH ADVANTAGE
CA454800OtherINTERPLAN
CA90204665OtherPACIFICARE
CA2689403OtherUNITED
CA000810801670OtherPHCS