Provider Demographics
NPI:1659542033
Name:PERALTA, MA CRISTINA AMOYO (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MA CRISTINA
Middle Name:AMOYO
Last Name:PERALTA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:MA CRISTINA
Other - Middle Name:BAUTISTA
Other - Last Name:AMOYO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:479 MOUNTAIN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-6714
Mailing Address - Country:US
Mailing Address - Phone:707-343-8720
Mailing Address - Fax:
Practice Address - Street 1:479 MOUNTAIN MEADOWS DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-6714
Practice Address - Country:US
Practice Address - Phone:707-343-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15266235Z00000X
CASP15266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist