Ilene L Cristdahl, MD LAC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

ND143 Issued in CA

Practice address

101 Providence Mine Rd
Suite 104
Nevada City, CA 95959-2939

Phone

(530) 470-8707

Fax

(530) 852-4996

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ilene Dahl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1194943183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROVIDENCE MINE RD",
            "address_2": "SUITE 104",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592939",
            "telephone_number": "530-470-8707",
            "fax_number": "530-852-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROVIDENCE MINE RD",
            "address_2": "SUITE 104",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592939",
            "telephone_number": "530-470-8707",
            "fax_number": "530-852-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTDAHL",
        "first_name": "ILENE",
        "middle_name": "L",
        "credential": "MD LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC2301",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILENE",
            "last_name": "DAHL",
            "credential": "N.D., LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eleanor Catherine Crawford, MFT INTERN
• Gina L Crawford, LICENSED PSYCH TECH
• Helen Crawford, MD
• Charles Craig Creasey
• Jean Louise Creasey, D.D.S.
• Erin Crow
• Bethany Lynn Crunelle, LCSW
• Ann C Cullinan, CADCII
• Laura Lynn Cummins, BSW
• Tara Ashley Cummiskey

• Naturopath in Nevada City, CA
• Providers in Nevada City, CA by specialty
• Naturopath in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.