Provider Demographics
NPI:1073944021
Name:VAN GAASBEEK, CRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:VAN GAASBEEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5776 SAINT AUGUSTINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8030
Mailing Address - Country:US
Mailing Address - Phone:904-448-4700
Mailing Address - Fax:904-448-4717
Practice Address - Street 1:6900 ALTAMA RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-9104
Practice Address - Country:US
Practice Address - Phone:904-720-1676
Practice Address - Fax:904-720-1731
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical