Provider Demographics
NPI:1518783745
Name:ROSSITER, KRISTINA MARIE OTT (ASW)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MARIE OTT
Last Name:ROSSITER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:MARIE
Other - Last Name:OTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1445 VETERANS MEMORIAL CIR STE B
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-3011
Mailing Address - Country:US
Mailing Address - Phone:530-822-7513
Mailing Address - Fax:530-822-7514
Practice Address - Street 1:1445 VETERANS MEMORIAL CIR STE B
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-3011
Practice Address - Country:US
Practice Address - Phone:530-822-7513
Practice Address - Fax:530-822-7514
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125208104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker