Healthcare Provider Details

I. General information

NPI: 1336227669
Provider Name (Legal Business Name): CHRISTINE SKOTZKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WOOD ST
EUREKA CA
95501-4413
US

IV. Provider business mailing address

415 E TAYLOR ST APT 4117
SAN JOSE CA
95112-7022
US

V. Phone/Fax

Practice location:
  • Phone: 707-268-2990
  • Fax: 707-476-4049
Mailing address:
  • Phone: 973-270-6814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG68142
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD466495
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA07024200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: