Healthcare Provider Details

I. General information

NPI: 1609991322
Provider Name (Legal Business Name): CRISTINE MARIE FERRERO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W SUNSET BLVD 7TH FLOOR
LOS ANGELES CA
90027-5861
US

IV. Provider business mailing address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 323-644-8528
  • Fax:
Mailing address:
  • Phone: 323-644-8528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number216623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: