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NPI Code Detail

MEDICARE: CHRISTINA HANSEN RD

MEDICARE: CHRISTINA HANSEN RD
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
1133V00000XRegistered Dietitian86106818CA

General Provider Information

NPI Number : 1376287912
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA HANSEN RD
Provider Business Mailing Address
First Line : 822 BARONIAL LN
Second Line :
City : ROCKLIN
State : CA
Zip : 95765-5668
Country : US
Telephone Number : 530-526-6670
Fax Number :
Provider Business Practice Location Address
First Line : 2315 STOCKTON BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2201
Country : US
Telephone Number : 916-734-2011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2022
Last Update Date : 04/20/2022

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Directions to “ CHRISTINA HANSEN RD” Practice Location

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