Provider Demographics
NPI:1710527262
Name:GONZALEZ FIGUEROA, CRISTINA (RDA)
Entity Type:Individual
Prefix:MISS
First Name:CRISTINA
Middle Name:
Last Name:GONZALEZ FIGUEROA
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-1544
Mailing Address - Country:US
Mailing Address - Phone:626-426-8848
Mailing Address - Fax:
Practice Address - Street 1:4924 STEWART AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-1544
Practice Address - Country:US
Practice Address - Phone:626-426-8848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA92586126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant