Healthcare Provider Details

I. General information

NPI: 1962469221
Provider Name (Legal Business Name): KRISTI DEE JORRIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 NORTH MARKET BLVD. SUITE 350
SACRAMENTO CA
95834
US

IV. Provider business mailing address

601 N.MARKET SUITE 350
SACRAMENTO CA
95834
US

V. Phone/Fax

Practice location:
  • Phone: 916-922-2771
  • Fax: 916-922-6609
Mailing address:
  • Phone: 916-922-2771
  • Fax: 916-922-8609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: