Healthcare Provider Details

I. General information

NPI: 1770363533
Provider Name (Legal Business Name): CHRISTINA WOHLFORTH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14631 N CAVE CREEK RD
PHOENIX AZ
85022-4159
US

IV. Provider business mailing address

5 HUTTON CENTRE DR STE 950
SANTA ANA CA
92707-8744
US

V. Phone/Fax

Practice location:
  • Phone: 855-434-7763
  • Fax: 949-281-5550
Mailing address:
  • Phone: 855-434-7763
  • Fax: 949-281-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number296627
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: