Provider Demographics
NPI:1831681816
Name:MADRIAGA, CHRISTIANNE LIZZETTE (RN PHN)
Entity type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:LIZZETTE
Last Name:MADRIAGA
Suffix:
Gender:F
Credentials:RN PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47923 OASIS ST STE 1-N2
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-9203
Mailing Address - Country:US
Mailing Address - Phone:760-863-8492
Mailing Address - Fax:
Practice Address - Street 1:47923 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-9203
Practice Address - Country:US
Practice Address - Phone:760-863-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHN556575163WC0400X
CA95163240163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management