Individual
CHARISSA ANN MARIE KAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4000
Mailing address
25288 VAN LEUVEN ST, LOMA LINDA, CA 92354-2212
(813) 504-6550
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
95167170
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002048
CA
Other
Enumeration date
03/27/2023
Last updated
05/08/2023
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