Provider Demographics
NPI:1174648836
Name:ZAMORA, CRISTINA GABRIELA (LMFT)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:GABRIELA
Last Name:ZAMORA
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 1:1940 GARNET AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3575
Mailing Address - Country:US
Mailing Address - Phone:858-255-1658
Mailing Address - Fax:
Practice Address - Street 1:272 CHURCH AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2718
Practice Address - Country:US
Practice Address - Phone:619-737-2989
Practice Address - Fax:619-737-2998
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89536106H00000X
171M00000X
CA119198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator