Healthcare Provider Details

I. General information

NPI: 1528316494
Provider Name (Legal Business Name): CHRISTINA MARGARITA BALDENEGRO RN/CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2012
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2487 S GILBERT RD STE 106-125
GILBERT AZ
85295-2804
US

IV. Provider business mailing address

2487 S GILBERT RD STE 106-125
GILBERT AZ
85295-2804
US

V. Phone/Fax

Practice location:
  • Phone: 480-695-8139
  • Fax: 480-219-5202
Mailing address:
  • Phone: 480-695-8139
  • Fax: 480-219-5202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number254511
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: