Provider Demographics
NPI:1598100091
Name:VEGA, CRISTINA MARIE (BA, MS, BCBA)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:VEGA
Suffix:
Gender:F
Credentials:BA, MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 PAINTER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3168
Mailing Address - Country:US
Mailing Address - Phone:562-695-6600
Mailing Address - Fax:562-698-6613
Practice Address - Street 1:8135 PAINTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3168
Practice Address - Country:US
Practice Address - Phone:562-695-6600
Practice Address - Fax:562-698-6613
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-7950103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst