Provider Demographics
NPI:1760756621
Name:AGUIRRE-KOLB, CHRISTINA ANTONIA (PHD, LEP, PPS)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:ANTONIA
Last Name:AGUIRRE-KOLB
Suffix:
Gender:F
Credentials:PHD, LEP, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E MONTECITO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3245
Mailing Address - Country:US
Mailing Address - Phone:805-467-8414
Mailing Address - Fax:
Practice Address - Street 1:520 E MONTECITO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3245
Practice Address - Country:US
Practice Address - Phone:805-847-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3283103TS0200X
CA33856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool