Provider Demographics
NPI:1942690599
Name:DALVA, CHRISTINE (FNP, RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:DALVA
Suffix:
Gender:F
Credentials:FNP, RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 MENDOCINO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2805
Mailing Address - Country:US
Mailing Address - Phone:707-545-4537
Mailing Address - Fax:707-545-6726
Practice Address - Street 1:555 S DORA ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5424
Practice Address - Country:US
Practice Address - Phone:707-462-3996
Practice Address - Fax:707-462-3363
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA836389163W00000X
CA95001970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse