Healthcare Provider Details

I. General information

NPI: 1689583395
Provider Name (Legal Business Name): JUSTIN JAMES RAY CHRISTENSEN NPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 THUNDER DR
OCEANSIDE CA
92056-4447
US

IV. Provider business mailing address

5800 LAKE MURRAY BLVD UNIT 76
LA MESA CA
91942-2516
US

V. Phone/Fax

Practice location:
  • Phone: 760-724-2193
  • Fax:
Mailing address:
  • Phone: 619-772-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95195998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: