Provider Demographics
NPI:1083157606
Name:NEGRETE, CHRISTOPHER GERARD (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GERARD
Last Name:NEGRETE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10416 EL RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-1126
Mailing Address - Country:US
Mailing Address - Phone:916-812-4477
Mailing Address - Fax:818-528-1261
Practice Address - Street 1:4911 VAN NUYS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-6802
Practice Address - Country:US
Practice Address - Phone:818-981-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005322363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95005322OtherCA NURSE PRACTIONER LICENSE