MEDICARE: CHRISTEN MIKIKO THOMPSON A.R.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP15359	CA

General Provider Information

NPI Number	:	1801820956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTEN MIKIKO THOMPSON A.R.N.P.

Provider Business Mailing Address
First Line	:	990 SONOMA AVE STE 2
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-4813
Country	:	US
Telephone Number	:	707-579-4239
Fax Number	:	707-579-0459

Provider Business Practice Location Address
First Line	:	990 SONOMA AVE STE 2
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-4813
Country	:	US
Telephone Number	:	707-579-4239
Fax Number	:	707-579-0459

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/17/2008

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