Healthcare Provider Details

I. General information

NPI: 1134311293
Provider Name (Legal Business Name): DR. KRISTIN RENEE BACHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23461 S POINTE DR STE 220
LAGUNA HILLS CA
92653-1523
US

IV. Provider business mailing address

35 BLUFF COVE DR
ALISO VIEJO CA
92656-8077
US

V. Phone/Fax

Practice location:
  • Phone: 949-855-1556
  • Fax: 949-951-2871
Mailing address:
  • Phone: 949-305-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: