Healthcare Provider Details

I. General information

NPI: 1225920796
Provider Name (Legal Business Name): CHRISTINE CECIL PNP-C, RCSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRIS TINSLEY

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 W 17TH ST
SANTA ANA CA
92706-3398
US

IV. Provider business mailing address

3825 BAKER ST
SAN DIEGO CA
92117-5706
US

V. Phone/Fax

Practice location:
  • Phone: 714-564-6219
  • Fax: 714-564-6219
Mailing address:
  • Phone: 619-317-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95034626
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95256460
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number95256460
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number562852
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number210244135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: