Provider Demographics
NPI:1720396963
Name:PADRON, CRISTINA (LVN)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:PADRON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 TYLEE ST
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-5664
Mailing Address - Country:US
Mailing Address - Phone:760-917-5522
Mailing Address - Fax:
Practice Address - Street 1:1270 TYLEE ST
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5664
Practice Address - Country:US
Practice Address - Phone:760-917-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA248759164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse