Provider Demographics
NPI:1659604080
Name:NOBRIGA, CHRISTINA VICTORIA (PHD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:VICTORIA
Last Name:NOBRIGA
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:VICTORIA
Other - Last Name:BRATLULND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, CCC-SLP
Mailing Address - Street 1:NICHOL HALL A506
Mailing Address - Street 2:SCHOOL OF ALLIED HEALTH PROFESSIONS
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-0001
Mailing Address - Country:US
Mailing Address - Phone:909-558-4995
Mailing Address - Fax:909-558-4305
Practice Address - Street 1:NICHOL HALL A506
Practice Address - Street 2:SCHOOL OF ALLIED HEALTH PROFESSIONS
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-0001
Practice Address - Country:US
Practice Address - Phone:909-558-4995
Practice Address - Fax:909-558-4305
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12042951OtherASHA