MEDICARE: MS. CHRISTINA B DEAL FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	N95013519	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP35013519	OTHER	CA	BOARD OF REGISTERED NURSES

General Provider Information

NPI Number	:	1578165031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA B DEAL FNP

Provider Business Mailing Address
First Line	:	1121 ADIRONDACK CT
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-6820
Country	:	US
Telephone Number	:	805-551-4085
Fax Number	:

Provider Business Practice Location Address
First Line	:	3631 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4869
Country	:	US
Telephone Number	:	323-373-2010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	05/11/2026

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