Provider Demographics
NPI:1669350310
Name:ALFARO-MADRID, KRISTAL (FNP- BC)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:
Last Name:ALFARO-MADRID
Suffix:
Gender:F
Credentials:FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 BOUQUET LN
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1592
Mailing Address - Country:US
Mailing Address - Phone:661-236-9152
Mailing Address - Fax:
Practice Address - Street 1:12737 GLENOAKS BLVD STE 26
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4776
Practice Address - Country:US
Practice Address - Phone:818-362-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily