Provider Demographics
NPI:1255432639
Name:MIRANDA, CHRISTINA (MS, PA-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 E VISTA CHINO # A7-758
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3559
Mailing Address - Country:US
Mailing Address - Phone:954-218-0138
Mailing Address - Fax:
Practice Address - Street 1:79215 CORPORATE CENTER DR STE 120
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-7232
Practice Address - Country:US
Practice Address - Phone:760-771-1111
Practice Address - Fax:760-564-1685
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17684363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant