Provider Demographics
NPI:1467837690
Name:QUIROZ, CHRISTA Y (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:Y
Last Name:QUIROZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:Y
Other - Last Name:CRAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 GARRISON ST APT 41
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-4754
Mailing Address - Country:US
Mailing Address - Phone:760-851-9591
Mailing Address - Fax:
Practice Address - Street 1:1330 E COOLEY DR
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3905
Practice Address - Country:US
Practice Address - Phone:909-580-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA982631041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical