Provider Demographics
NPI:1528530904
Name:ZACHRESON, CHRISTIE CAMBRIDGE (LM, CPM)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:CAMBRIDGE
Last Name:ZACHRESON
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 RIFLE CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-9643
Mailing Address - Country:US
Mailing Address - Phone:916-412-7140
Mailing Address - Fax:
Practice Address - Street 1:117 RIFLE CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-9643
Practice Address - Country:US
Practice Address - Phone:916-412-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-22
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty