Healthcare Provider Details

I. General information

NPI: 1356828248
Provider Name (Legal Business Name): KRISTINA PALADINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TRANCAS ST
NAPA CA
94558-2906
US

IV. Provider business mailing address

PO BOX 2452
NAPA CA
94558-0245
US

V. Phone/Fax

Practice location:
  • Phone: 707-252-4411
  • Fax:
Mailing address:
  • Phone: 707-812-0981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: