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NPI Code Detail

MEDICARE: MS. CHRISTINE MARIE BETZOLD FNP

MEDICARE:  MS. CHRISTINE MARIE BETZOLD  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
1363LF0000XFamily Nurse Practitioner426089CA

General Provider Information

NPI Number : 1942284906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE MARIE BETZOLD FNP
Provider Business Mailing Address
First Line : 12782 ALONZO COOK ST
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92845-2609
Country : US
Telephone Number : 714-892-9345
Fax Number :
Provider Business Practice Location Address
First Line : 455 S MAIN ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3835
Country : US
Telephone Number : 714-532-7607
Fax Number : 714-289-4023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 03/07/2023

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Directions to “ MS. CHRISTINE MARIE BETZOLD FNP” Practice Location

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