Basic Information
Provider Information
NPI: 1831842491
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEST
FirstName: CHRISTINA
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6224 CAMINITO SALADO
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921117224
CountryCode: US
TelephoneNumber: 5104147003
FaxNumber:  
Practice Location
Address1: 4309 3RD AVE
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921031407
CountryCode: US
TelephoneNumber: 6198764502
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/02/2022
LastUpdateDate: 02/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X95270608CAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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