Healthcare Provider Details

I. General information

NPI: 1871393199
Provider Name (Legal Business Name): KRISTEN MARIE SCHNEEWEIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN FOUTZ

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 PLACER ST
REDDING CA
96001-1170
US

IV. Provider business mailing address

1444 LEAR WAY
REDDING CA
96001-2323
US

V. Phone/Fax

Practice location:
  • Phone: 530-246-5710
  • Fax:
Mailing address:
  • Phone: 530-828-6172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA66597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: