Provider Demographics
NPI:1639293764
Name:CRUZIO, CRISTIAN J (BA)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:J
Last Name:CRUZIO
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 DEARBORN PL APT 41
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-3532
Mailing Address - Country:US
Mailing Address - Phone:805-964-5774
Mailing Address - Fax:
Practice Address - Street 1:4570 CALLE REAL
Practice Address - Street 2:CASA DEL MURAL
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1306
Practice Address - Country:US
Practice Address - Phone:805-692-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health