Provider Demographics
NPI:1598344822
Name:MCCREARY, CHRISTINA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8840 N MAGNOLIA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4516
Mailing Address - Country:US
Mailing Address - Phone:619-749-7059
Mailing Address - Fax:619-749-7069
Practice Address - Street 1:8840 N MAGNOLIA AVE STE 220
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4516
Practice Address - Country:US
Practice Address - Phone:619-749-7059
Practice Address - Fax:619-749-7069
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11528235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist