Provider Demographics
NPI:1417494097
Name:CUNIBERTI, KRISTIN (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CUNIBERTI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:MCLAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:4039 OBSIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-0464
Mailing Address - Country:US
Mailing Address - Phone:909-731-8774
Mailing Address - Fax:
Practice Address - Street 1:4039 OBSIDIAN RD
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-0464
Practice Address - Country:US
Practice Address - Phone:909-731-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-25574103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst