Healthcare Provider Details

I. General information

NPI: 1366784373
Provider Name (Legal Business Name): CHRISTINA ELIZABETH WYNN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SUTTER PL
DAVIS CA
95616-6201
US

IV. Provider business mailing address

1141 PEAR TREE LN
NAPA CA
94558-6484
US

V. Phone/Fax

Practice location:
  • Phone: 530-285-3202
  • Fax:
Mailing address:
  • Phone: 707-254-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: