Healthcare Provider Details

I. General information

NPI: 1124093208
Provider Name (Legal Business Name): KRISTINE A GIRARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINE A YEW M.D.

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 01/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US

IV. Provider business mailing address

2500 ALHAMBRA AVE # 4E-01
MARTINEZ CA
94553-3156
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5713
  • Fax: 925-370-5770
Mailing address:
  • Phone: 925-370-5713
  • Fax: 925-370-5770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number79421
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number79421
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG88798
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG88798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: