Provider Demographics
NPI:1568807451
Name:PRICE, CHRISTA ROSE (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:ROSE
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:MISS
Other - First Name:CHRISTA
Other - Middle Name:ROSE
Other - Last Name:SPANGENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:15204 VIRTUOSO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-0386
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15204 VIRTUOSO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-0386
Practice Address - Country:US
Practice Address - Phone:408-833-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA797980163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse