Provider Demographics
NPI:1366657603
Name:CRIST, CYNTHIA (MSN, FNP, APRN-BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CRIST
Suffix:
Gender:F
Credentials:MSN, FNP, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13833 DEANLY WAY
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-4849
Mailing Address - Country:US
Mailing Address - Phone:619-443-6599
Mailing Address - Fax:619-443-6599
Practice Address - Street 1:4033 3RD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2117
Practice Address - Country:US
Practice Address - Phone:619-299-2570
Practice Address - Fax:619-299-1834
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily