Provider Demographics
NPI:1629316021
Name:GAUNCE, CHRISTINA LYNN (RD)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:LYNN
Last Name:GAUNCE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8060 AVENIDA SECRETO
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-9550
Mailing Address - Country:US
Mailing Address - Phone:760-889-0694
Mailing Address - Fax:760-943-9698
Practice Address - Street 1:2910 JEFFERSON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2356
Practice Address - Country:US
Practice Address - Phone:760-889-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1022167133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered