Individual provider Active NPI

Christine Tran Holguin, P.A

  • Physician Assistant
  • San Bernardino, CA
National Provider Identifier
1265457923
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18083 Issued in CA
Practice address
1805 Medical Center Dr
San Bernardino, CA 92411
Phone
(909) 806-1598
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18083 CA Primary

Addresses

Primary practice location

1805 Medical Center Dr
San Bernardino, CA 92411

Mailing address

2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000320 CA Practitioner - Physician Assistant 1254352065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
18083CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Sep 6, 2005 Accepting new patients
Cep America - California Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: cholguin315505@direct.llu.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1265457923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MEDICAL CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92411",
            "telephone_number": "909-806-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLGUIN",
        "first_name": "CHRISTINE",
        "middle_name": "TRAN",
        "credential": "P.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.