MEDICARE: KRISTINA EGE DYSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1356271704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA EGE DYSON

Provider Business Mailing Address
First Line	:	PO BOX 400
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-0400
Country	:	US
Telephone Number	:	530-564-0015
Fax Number	:	530-527-0232

Provider Business Practice Location Address
First Line	:	1860 WALNUT ST BLDG A
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-3611
Country	:	US
Telephone Number	:	530-564-0015
Fax Number	:	530-527-0232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “ KRISTINA EGE DYSON ” Practice Location

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