Individual
CHRISTINA KALLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 499-6830
Mailing address
922 ELY BLVD S, PETALUMA, CA 94954-4608
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
587816
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
587818
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
587816
CA
CA
Enumeration date
08/13/2017
Last updated
03/17/2018
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