Provider Demographics
NPI:1508200700
Name:AVILES, CRISTINA VANESSA (LMFT)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:VANESSA
Last Name:AVILES
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 1:41 E. FOOTHILL BLVD.
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-701-4249
Mailing Address - Fax:
Practice Address - Street 1:7630 PAINTER AVENUE, SUITE C
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602
Practice Address - Country:US
Practice Address - Phone:562-203-0177
Practice Address - Fax:626-737-6034
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist