Provider Demographics
NPI:1407414071
Name:PEREZ, CHRISTINA (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
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 1:8885 RIO SAN DIEGO DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1624
Mailing Address - Country:US
Mailing Address - Phone:619-719-1341
Mailing Address - Fax:
Practice Address - Street 1:8885 RIO SAN DIEGO DR STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1624
Practice Address - Country:US
Practice Address - Phone:619-719-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist