Provider Demographics
NPI:1821644493
Name:IGNACIO, CRISELDA NAVARRO
Entity Type:Individual
Prefix:
First Name:CRISELDA
Middle Name:NAVARRO
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8229 PURITAN ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4313
Mailing Address - Country:US
Mailing Address - Phone:562-716-8358
Mailing Address - Fax:
Practice Address - Street 1:8229 PURITAN ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4313
Practice Address - Country:US
Practice Address - Phone:562-716-8358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider