Healthcare Provider Details

I. General information

NPI: 1306628540
Provider Name (Legal Business Name): CHRISTINA E RAINES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N SEE VEE LN
BISHOP CA
93514-8130
US

IV. Provider business mailing address

4 COMSTOCK CIR APT 105
PALO ALTO CA
94305-7647
US

V. Phone/Fax

Practice location:
  • Phone: 760-873-8461
  • Fax: 760-873-3908
Mailing address:
  • Phone: 559-916-9948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number64414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: