Provider Demographics
NPI:1568296416
Name:DAIL, CHRISTINA I
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DAIL
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28999 OLD TOWN FRONT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5806
Mailing Address - Country:US
Mailing Address - Phone:951-551-7036
Mailing Address - Fax:
Practice Address - Street 1:41604 DATE ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-1016
Practice Address - Country:US
Practice Address - Phone:951-551-7036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25673225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics