Healthcare Provider Details

I. General information

NPI: 1629983887
Provider Name (Legal Business Name): CHRISTINA ANN ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 W ACACIA AVE STE 101
HEMET CA
92543-4080
US

IV. Provider business mailing address

760 W ACACIA AVE STE 101
HEMET CA
92543-4080
US

V. Phone/Fax

Practice location:
  • Phone: 951-766-8403
  • Fax:
Mailing address:
  • Phone: 858-652-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95041043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: