Provider Demographics
NPI:1801021209
Name:RITA, CRISTINA JANE
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:JANE
Last Name:RITA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 SEELEY ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-2501
Mailing Address - Country:US
Mailing Address - Phone:510-557-1623
Mailing Address - Fax:
Practice Address - Street 1:1223 SEELEY ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-2501
Practice Address - Country:US
Practice Address - Phone:510-557-1623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist