Provider Demographics
NPI:1962728329
Name:THREATT, JAMES CHRISTOPHER (RN)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:THREATT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2872 BLENHEIM AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3207
Mailing Address - Country:US
Mailing Address - Phone:415-342-0646
Mailing Address - Fax:
Practice Address - Street 1:2872 BLENHEIM AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3207
Practice Address - Country:US
Practice Address - Phone:415-342-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637765163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health