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General NPI Number Information
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NPI Number | 1417807595
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Entity Type | Individual
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Provider Name | CHRISTINA BLOOM RN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3518
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Country | US
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Telephone | 628-206-8312
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Fax |
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Provider Business Mailing Address
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Address Line | 29 BENNIT AVE
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1540
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Country | US
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Telephone | 442-204-4383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 425977
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License Number State | CA
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