Basic Information
| Provider Information | |||||||||
| NPI: | 1467904425 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHRISTOPHER G. NEGRETE ACNP, A NURSING CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10416 EL RANCHO DR | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906061126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168124477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10416 EL RANCHO DR | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906061126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168124477 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2016 | ||||||||
| LastUpdateDate: | 10/25/2016 | ||||||||
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| AuthorizedOfficialLastName: | NEGRETE | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | GERARD | ||||||||
| AuthorizedOfficialTitleorPosition: | ACUTE CARE NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 9168124477 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171W00000X | 95005322 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Contractor |
ID Information
| ID | Type | State | Issuer | Description | 95005322 | 01 | CA | NURSE PRACTITIONER AND FURNISHING NUMBER | OTHER | 822439 | 01 | CA | REGISTERED NURSE | OTHER |