Provider Demographics
NPI:1639817737
Name:CHOA, CHRISTINA DARAVAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DARAVAN
Last Name:CHOA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:DARAVAN
Other - Last Name:RATHAVONGSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2547 SILVERCREST CT
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1138
Mailing Address - Country:US
Mailing Address - Phone:510-485-9362
Mailing Address - Fax:
Practice Address - Street 1:400 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily