Provider Demographics
NPI:1598488553
Name:CISTRONE, MONICA CATHERINE (FNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:CATHERINE
Last Name:CISTRONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9239 CAMPO RD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1122
Mailing Address - Country:US
Mailing Address - Phone:858-648-0755
Mailing Address - Fax:
Practice Address - Street 1:9239 CAMPO RD STE A
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1122
Practice Address - Country:US
Practice Address - Phone:858-648-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CA95023330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program