Provider Demographics
NPI:1205634144
Name:ADAIMY, KRISTINE (BSN, RN, PHN, CEN)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:ADAIMY
Suffix:
Gender:
Credentials:BSN, RN, PHN, CEN
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 S AKELEY DR
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-3721
Mailing Address - Country:US
Mailing Address - Phone:626-319-3760
Mailing Address - Fax:
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-847-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95137850163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency