Provider Demographics
NPI:1902445968
Name:CORTEZ, CARINA CRYSTAL (WHNP)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:CRYSTAL
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:CRYSTAL
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:WHNP
Mailing Address - Street 1:2930 W 235TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4148
Mailing Address - Country:US
Mailing Address - Phone:310-367-0013
Mailing Address - Fax:
Practice Address - Street 1:20911 EARL ST STE 440
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4355
Practice Address - Country:US
Practice Address - Phone:310-793-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-22
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013425363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty