Provider Demographics
NPI:1225920796
Name:CECIL, CHRISTINE (PNP-C, RCSN)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:CECIL
Suffix:
Gender:F
Credentials:PNP-C, RCSN
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:TINSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3825 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5706
Mailing Address - Country:US
Mailing Address - Phone:619-317-8181
Mailing Address - Fax:
Practice Address - Street 1:1530 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3398
Practice Address - Country:US
Practice Address - Phone:714-564-6219
Practice Address - Fax:714-564-6219
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95256460163W00000X, 163WC1400X
CA562852163WC1500X
CA95034626363LP0200X
CA210244135163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics