Healthcare Provider Details

I. General information

NPI: 1558240283
Provider Name (Legal Business Name): KRISTEN WARNER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WHEELER AVE STE C
ARCADIA CA
91006-3240
US

IV. Provider business mailing address

2820 SWITCHBACK LN
CORONA CA
92882-5885
US

V. Phone/Fax

Practice location:
  • Phone: 626-294-4866
  • Fax:
Mailing address:
  • Phone: 951-727-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2116004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: