Christy Rae Bascochea, RN

Individual provider Active NPI Registered Nurse · Fortuna, CA

NPI 1316447808 · NPPES record last updated Feb 20, 2018

Key facts

NPI
1316447808
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
622971 (CA)
Practice address
3306 Renner Dr
Fortuna, CA 95540-3120
Phone
(707) 725-6101
Fax
(707) 725-2978
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
622971CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 622971 CA Yes

Addresses

Primary practice location

3306 Renner Dr
Fortuna, CA 95540-3120

Mailing address

670 9TH St Ste 203
Arcata, CA 95521-6249
Phone (707) 826-8633

Other providers in Fortuna, CA

All providers in Fortuna, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.