Provider Demographics
NPI:1548462518
Name:FESTEJO, CHRISTINA DONATO (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DONATO
Last Name:FESTEJO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9484 POPPYFIELD CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7924
Mailing Address - Country:US
Mailing Address - Phone:909-987-4269
Mailing Address - Fax:
Practice Address - Street 1:9484 POPPYFIELD CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7924
Practice Address - Country:US
Practice Address - Phone:909-987-4269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN362904163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health