Provider Demographics
NPI:1780857110
Name:COVINGTON, CHRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COVINGTON
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 1:13053 POWAY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4532
Mailing Address - Country:US
Mailing Address - Phone:858-748-3030
Mailing Address - Fax:
Practice Address - Street 1:13053 POWAY RD
Practice Address - Street 2:SUITE A
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4532
Practice Address - Country:US
Practice Address - Phone:858-748-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12092OtherNURSE PRACTITIONER