MEDICARE: CHRISTINA WOHLFORTH NP

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	296627	AZ

General Provider Information

NPI Number	:	1770363533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA WOHLFORTH NP

Provider Business Mailing Address
First Line	:	5 HUTTON CENTRE DR STE 950
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-8744
Country	:	US
Telephone Number	:	855-434-7763
Fax Number	:	949-281-5550

Provider Business Practice Location Address
First Line	:	14631 N CAVE CREEK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4159
Country	:	US
Telephone Number	:	855-434-7763
Fax Number	:	949-281-5550

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

Provider Enumeration Date	:	09/29/2023
Last Update Date	:	12/04/2025

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