Provider Demographics
NPI:1073801544
Name:BRUZZONE, CRISTINE ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINE
Middle Name:ELIZABETH
Last Name:BRUZZONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:CRISTINE
Other - Middle Name:ELIZABETH
Other - Last Name:BOYAGGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 PENINSULA CTR STE 379E
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3509
Mailing Address - Country:US
Mailing Address - Phone:310-855-3990
Mailing Address - Fax:424-276-7676
Practice Address - Street 1:2790 SKYPARK DR STE 205
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5345
Practice Address - Country:US
Practice Address - Phone:310-855-3990
Practice Address - Fax:424-276-7676
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS2012825225C00000X
CAPSY34168103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor