Provider Demographics
NPI:1669626008
Name:MOORE, MARIA CRISTINA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CRISTINA
Last Name:MOORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MA
Other - Middle Name:CRISTINA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:550 N FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2361
Mailing Address - Country:US
Mailing Address - Phone:714-647-4172
Mailing Address - Fax:714-647-1865
Practice Address - Street 1:550 N FLOWER ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2361
Practice Address - Country:US
Practice Address - Phone:714-647-4172
Practice Address - Fax:714-647-1865
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA632564163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice