Individual
CHRISTIAN KENSHIN JOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
Mailing address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
701025
CA
163WP2201X
Ambulatory Care Registered Nurse
701025
CA
163WW0000X
Wound Care Registered Nurse
701025
CA
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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