Healthcare Provider Details

I. General information

NPI: 1700171436
Provider Name (Legal Business Name): CHRISTINA LAM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 OBERLIN DR STE 100
SAN DIEGO CA
92121-4715
US

IV. Provider business mailing address

5755 OBERLIN DR STE 100
SAN DIEGO CA
92121-4715
US

V. Phone/Fax

Practice location:
  • Phone: 858-630-3455
  • Fax: 833-428-2059
Mailing address:
  • Phone: 858-630-3455
  • Fax: 833-428-2059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number19870
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number705244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: