Healthcare Provider Details

I. General information

NPI: 1225416365
Provider Name (Legal Business Name): KRISTEN YEE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SONOMA AVE STE 112
SANTA ROSA CA
95405-4813
US

IV. Provider business mailing address

1111 SONOMA AVE STE 112
SANTA ROSA CA
95405-4813
US

V. Phone/Fax

Practice location:
  • Phone: 707-525-8080
  • Fax: 707-579-8820
Mailing address:
  • Phone: 707-525-8080
  • Fax: 707-579-8820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberA91088
License Number StateCA

VIII. Authorized Official

Name: DR. KRISTEN S YEE
Title or Position: MD
Credential: MD., PC.
Phone: 707-525-8080