Provider Demographics
NPI:1164145991
Name:BARRETT, CRISTINA MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 BALBOA BLVD STE 285
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6398
Mailing Address - Country:US
Mailing Address - Phone:818-997-7117
Mailing Address - Fax:
Practice Address - Street 1:10515 BALBOA BLVD STE 285
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6398
Practice Address - Country:US
Practice Address - Phone:818-997-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily