=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144068347
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE JACQUELINE ATTEW PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2024
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15635 ALTON PKWY STE 350
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92618-7333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-528-6300
-----------------------------------------------------
Fax | 204-222-3483
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23345 STIRRUP DR
-----------------------------------------------------
City | DIAMOND BAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91765-2042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-670-5118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 95034578
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------