Provider Demographics
NPI:1073499760
Name:CAMPOS, PATRICIA CRISTINA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CRISTINA
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 N ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1529
Mailing Address - Country:US
Mailing Address - Phone:818-383-8866
Mailing Address - Fax:
Practice Address - Street 1:1 DANIEL BURNHAM CT APT 1406
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5464
Practice Address - Country:US
Practice Address - Phone:818-383-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9510921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse