1134584592 NPI number — DR. CHRISTINA VALENCIA DUNN PHARM.D., BCPP

Table of content: DR. CHRISTINA VALENCIA DUNN PHARM.D., BCPP (NPI 1134584592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134584592 NPI number — DR. CHRISTINA VALENCIA DUNN PHARM.D., BCPP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNN
Provider First Name:
CHRISTINA
Provider Middle Name:
VALENCIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D., BCPP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134584592
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1622 COPPER CREEK CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHULA VISTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91913-2638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-699-2192
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1380 EL CAJON BLVD
Provider Second Line Business Practice Location Address:
SRS PHARMACY BENEFITS ADMINISTRATION
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-5703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-590-3380
Provider Business Practice Location Address Fax Number:
619-590-3343
Provider Enumeration Date:
12/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  60835 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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