Provider Demographics
NPI:1306314059
Name:NARANJO, CHRISTINA BROOKE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:BROOKE
Last Name:NARANJO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 N BEDFORD DR STE 306
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4320
Mailing Address - Country:US
Mailing Address - Phone:310-274-4401
Mailing Address - Fax:
Practice Address - Street 1:436 N BEDFORD DR STE 306
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4320
Practice Address - Country:US
Practice Address - Phone:310-274-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA56874363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA56874OtherCALIFORNIA PHYSICIAN ASSISTANT LICENSE
1161709OtherNCCPA CERTIFICATION
CAMN5307726OtherDEA NUMBER