Healthcare Provider Details

I. General information

NPI: 1740653013
Provider Name (Legal Business Name): CHRISTINA FLORES SUDCC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2015
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14320 PALM DR
DESERT HOT SPRINGS CA
92240-6874
US

IV. Provider business mailing address

14320 PALM DR
DESERT HOT SPRINGS CA
92240-6874
US

V. Phone/Fax

Practice location:
  • Phone: 760-770-2264
  • Fax: 760-770-2230
Mailing address:
  • Phone: 760-770-2264
  • Fax: 760-770-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number5960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: