Provider Demographics
NPI:1639755762
Name:MILLON, TINA CHRISTA (NP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:CHRISTA
Last Name:MILLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E LATHAM AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4423
Mailing Address - Country:US
Mailing Address - Phone:951-929-8400
Mailing Address - Fax:
Practice Address - Street 1:1225 E LATHAM AVE STE A
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4423
Practice Address - Country:US
Practice Address - Phone:951-929-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648171163WW0101X
CA95020856363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory