Provider Demographics
NPI:1821314675
Name:GOLDSTEIN, CRISTINA RENEE (IMF)
Entity Type:Individual
Prefix:MISS
First Name:CRISTINA
Middle Name:RENEE
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3420
Mailing Address - Country:US
Mailing Address - Phone:619-281-3706
Mailing Address - Fax:760-796-4397
Practice Address - Street 1:829 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3420
Practice Address - Country:US
Practice Address - Phone:619-281-3706
Practice Address - Fax:760-796-4397
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist