Provider Demographics
NPI:1073588661
Name:SANDERS, CHRISTINA A (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:SANDERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SANTA FE DR
Mailing Address - Street 2:STE 204
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5179
Mailing Address - Country:US
Mailing Address - Phone:858-784-5906
Mailing Address - Fax:858-784-5933
Practice Address - Street 1:10666 N TORREY PINES RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1027
Practice Address - Country:US
Practice Address - Phone:858-554-8018
Practice Address - Fax:858-784-5933
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN638337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN638337Medicaid
CARN638337Medicaid
WNP14902AMedicare PIN