Provider Demographics
NPI:1427875848
Name:SUNDBY, CHRISTINE DIANE (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DIANE
Last Name:SUNDBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:DIANE
Other - Last Name:RIORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2810 AMULET ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3137
Mailing Address - Country:US
Mailing Address - Phone:702-810-4284
Mailing Address - Fax:
Practice Address - Street 1:7910 FROST ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2776
Practice Address - Country:US
Practice Address - Phone:858-634-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily