Kristoffer Allan Ancho, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in La Jolla, CA. Individual provider (NPI-1).
NPI number1700199205
StatusActive
Last updated in NPPESJun 21, 2022
Details
- NPI
- 1700199205
- Entity type
- Individual (NPI-1)
- Name
- Kristoffer Allan Ancho
- Credential
- PMHNP-BC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 26, 2010
- Certification date
- Jun 21, 2022
- Last updated
- Jun 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 95020594 | CA | Yes |
Practice location
4180 La Jolla Village Dr Ste 240La Jolla, CA 92037-1471
Phone 866-277-2659 · Fax 858-779-2511
Mailing address
5275 Market StSuite E
San Diego, CA 92114-2212
Phone 619-857-6004 · Fax 619-263-7343
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