Provider Demographics
NPI:1902548316
Name:BORAH, CHRISTINA ELAINE (MHRS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELAINE
Last Name:BORAH
Suffix:
Gender:F
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 SANTA RITA PL
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-1948
Mailing Address - Country:US
Mailing Address - Phone:951-797-3166
Mailing Address - Fax:
Practice Address - Street 1:532 SANTA RITA PL
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-1948
Practice Address - Country:US
Practice Address - Phone:951-797-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner