Basic Information
| Provider Information | |||||||||
| NPI: | 1578514493 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHRISTENSON | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MPAS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 COHASSET RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303423686 | ||||||||
| FaxNumber: | 5306424199 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 COHASSET RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959262235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303423686 | ||||||||
| FaxNumber: | 5306424199 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 04/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA00842 | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.