Healthcare Provider Details

I. General information

NPI: 1700766433
Provider Name (Legal Business Name): CHRISTIANA MAIELLA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OCEANGATE STE 200
LONG BEACH CA
90802-4317
US

IV. Provider business mailing address

3933 JEWELL ST APT B3
SAN DIEGO CA
92109-6082
US

V. Phone/Fax

Practice location:
  • Phone: 888-562-5442
  • Fax:
Mailing address:
  • Phone: 508-523-5934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95034665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: