Provider Demographics
NPI:1902500341
Name:BUNALES, KRISTINE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:
Last Name:BUNALES
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:BUTZLOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3801 E PCH
Mailing Address - Street 2:APT 321
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804
Mailing Address - Country:US
Mailing Address - Phone:562-618-9845
Mailing Address - Fax:
Practice Address - Street 1:3033 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3156
Practice Address - Country:US
Practice Address - Phone:714-827-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95256790163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse