Provider Demographics
NPI:1871005322
Name:HORTON, CHRISTINA ELAINE (LVN/LPT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ELAINE
Last Name:HORTON
Suffix:
Gender:F
Credentials:LVN/LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15165 COLVILLE CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-6754
Mailing Address - Country:US
Mailing Address - Phone:951-289-2631
Mailing Address - Fax:
Practice Address - Street 1:11424 CHAMBERLAINE WAY STE 11&12
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-2869
Practice Address - Country:US
Practice Address - Phone:760-246-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN689190164X00000X
CAPT38095167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No164X00000XNursing Service ProvidersLicensed Vocational Nurse