Provider Demographics
NPI:1952898488
Name:YEE, KRISTA D (MS)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:D
Last Name:YEE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N SUNRISE AVE STE 1105
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2931
Mailing Address - Country:US
Mailing Address - Phone:916-771-8255
Mailing Address - Fax:916-771-8211
Practice Address - Street 1:151 N SUNRISE AVE STE 1105
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2931
Practice Address - Country:US
Practice Address - Phone:916-771-8255
Practice Address - Fax:916-771-8211
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18150225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist