Most Relevant Information
Provider Data
| NPI Number: | 1003450214 |
| Provider Name: | CHRISTIANA DE JESUS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA57162 |
Most Important Dates
| Enumeration Date: | 10/30/2019 |
| Last Updated: | 12/16/2019 |
Provider Practice Location
1362 GLENTHORPE DR
WALNUT
CA
917893858
Practice Location Phone/Fax
| Phone: | 9095767810 |
| Fax: |
Provider Mailing Location
770 MAGNOLIA AVE STE 2A
CORONA
CA
928793122
Provider Mailing Phone/Fax
| Phone: | 9517368144 |
| Fax: |