Healthcare Provider Details

I. General information

NPI: 1558127639
Provider Name (Legal Business Name): KRISTINA ISABEL NGUYEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N LINCOLN AVE STE 100
CORONA CA
92882-1853
US

IV. Provider business mailing address

25334 HIGH NOON CT
MENIFEE CA
92584-9390
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number9503866
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95029770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: