Provider Demographics
NPI:1952535684
Name:ANDERSEN, KRIS (DVM)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:ANDERSEN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 ELKHORN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-3201
Mailing Address - Country:US
Mailing Address - Phone:916-332-2845
Mailing Address - Fax:
Practice Address - Street 1:3451 ELKHORN BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-3201
Practice Address - Country:US
Practice Address - Phone:916-332-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-09
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11362174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian