Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Christy Park

Individual provider Nurse Practitioner · NPI 1023673803

Christy Park is a Nurse Practitioner in Lake Forest, California. Qualified in 2025, 1 year ago. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

2952 Viejo Ridge North Dr
Lake Forest, CA 92679-1647
Phone: (714) 788-9790
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95036963 (CA)

Record details

NPI number1023673803
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 7, 2019
Last updated in NPPESNovember 26, 2025
Certification dateNovember 26, 2025
Mailing address2952 Viejo Ridge North Dr, Lake Forest, CA 92679-1647

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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