Basic Information
| Provider Information | |||||||||
| NPI: | 1366657603 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRIST | ||||||||
| FirstName: | CYNTHIA | ||||||||
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| Credential: | MSN, FNP, APRN-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13833 DEANLY WAY | ||||||||
| Address2: | |||||||||
| City: | LAKESIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920404849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194436599 | ||||||||
| FaxNumber: | 6194436599 | ||||||||
| Practice Location | |||||||||
| Address1: | 4033 3RD AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921032117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192992570 | ||||||||
| FaxNumber: | 6192991834 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 13299 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.