Healthcare Provider Details

I. General information

NPI: 1891023883
Provider Name (Legal Business Name): CHRISTINE CRAFT JOSEPH RN, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2009
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 CALLE FRUTAS
SAN CLEMENTE CA
92673-7002
US

IV. Provider business mailing address

22 CALLE FRUTAS
SAN CLEMENTE CA
92673-7002
US

V. Phone/Fax

Practice location:
  • Phone: 949-350-4603
  • Fax:
Mailing address:
  • Phone: 949-350-4603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number443399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: