Individual
CHRISTIA BACTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
328 S CENTRAL AVE STE 211, MEDFORD, OR 97501
(541) 531-5447
Mailing address
PO BOX 582, MEDFORD, OR 97501-0039
(541) 531-5447
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A4792
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500706503
—
OR
Enumeration date
08/11/2014
Last updated
06/25/2018
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