Active NPI
Christina Park, FNP-C
- Family Nurse Practitioner
- Anaheim, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95029338
- Practice address
- 5630 E Santa Ana Canyon Rd Ste 100
Anaheim, CA 92807-3122 - Phone
- (714) 257-6170
- NPI assigned
- Mar 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95029338 | CA | Primary |
Addresses
Primary practice location
5630 E Santa Ana Canyon Rd Ste 100
Anaheim, CA 92807-3122
Mailing address
1142 S Diamond Bar Blvd # 383
Diamond Bar, CA 91765-2203
Other practice location 1
15855 Pomona Rincon Rd
Chino Hills, CA 91709-5572
Phone (909) 264-8666
Other practice location 2
2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 628-3300
Other practice location 3
2251 N Harbor Blvd
Fullerton, CA 92835-2601
Phone (714) 449-6230
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006
1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350
2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175
5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 602-2400
Hospital & facility affiliations
- Providence St. Jude Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95029338 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients |
Locations
5630 E Santa Ana Canyon Rd
Ste 100
Anaheim, CA 92807
Phone (714) 257-6170
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
2501 E Chapman Ave
Orange, CA 92869
Phone (714) 628-3300
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
Interoperability endpoints
- cpark2519249@oc.providencedirect.org
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
-
- General Acute Care Hospital
- Brea, CA
- NPI 1891904942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713916800000",
"number": "1295592293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1142 S DIAMOND BAR BLVD # 383",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917652203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5630 E SANTA ANA CANYON RD STE 100",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073122",
"telephone_number": "714-257-6170"
}
],
"practiceLocations": [
{
"address_1": "15855 Pomona Rincon Rd",
"address_purpose": "LOCATION",
"city": "Chino Hills",
"state": "CA",
"postal_code": "917095572",
"country_code": "US",
"telephone_number": "909-264-8666",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 E Chapman Ave",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928693204",
"country_code": "US",
"telephone_number": "714-628-3300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2251 N Harbor Blvd",
"address_purpose": "LOCATION",
"city": "Fullerton",
"state": "CA",
"postal_code": "928352601",
"country_code": "US",
"telephone_number": "714-449-6230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "CHRISTINA",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-05",
"last_updated": "2024-04-24",
"certification_date": "2024-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95029338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.