Individual
KRISTYNA DORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
115 VIA MONTE PICAYO, SAN CLEMENTE, CA 92673-6601
(949) 632-9043
Mailing address
115 VIA MONTE PICAYO, SAN CLEMENTE, CA 92673
(949) 632-9043
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
437684
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
437684
BRN
CA
Enumeration date
03/02/2022
Last updated
03/02/2022
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