Provider Demographics
NPI:1033497334
Name:PEREZ, CRISTINA MARIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:MARIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W VALLEY BLVD STE 104-253
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-5707
Mailing Address - Country:US
Mailing Address - Phone:818-536-9002
Mailing Address - Fax:
Practice Address - Street 1:425 W VALLEY BLVD STE 104-253
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-5707
Practice Address - Country:US
Practice Address - Phone:818-536-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90544106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7368OtherMEDI-CAL
CA7708OtherMEDI-CAL
CA7184OtherMEDI-CAL
CA7667OtherMEDI-CAL