Basic Information
Provider Information
NPI: 1487087946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOREHKASH
FirstName: CHRIS
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3780 ROSIN CT STE 110
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958341698
CountryCode: US
TelephoneNumber: 9164410226
FaxNumber:  
Practice Location
Address1: 1400 A ST BLDG A
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958110612
CountryCode: US
TelephoneNumber: 9164401500
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/19/2013
LastUpdateDate: 08/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174H00000X  Y Other Service ProvidersHealth Educator 

No ID Information.


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