Provider Demographics
NPI:1215149315
Name:DORN, CHRISTINA J
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:DORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:LOYALTON
Mailing Address - State:CA
Mailing Address - Zip Code:96118-0265
Mailing Address - Country:US
Mailing Address - Phone:530-993-6746
Mailing Address - Fax:530-993-6759
Practice Address - Street 1:22 MAIDEN LANE
Practice Address - Street 2:
Practice Address - City:DOWNIEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95936
Practice Address - Country:US
Practice Address - Phone:530-289-3711
Practice Address - Fax:530-289-3716
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor