Provider Demographics
NPI:1851444780
Name:VENTURA, KRISTINA (MFT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:VENTURA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 VISTA HERMOSA
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3948
Mailing Address - Country:US
Mailing Address - Phone:925-285-1866
Mailing Address - Fax:
Practice Address - Street 1:201 E ALASKA AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-644-0485
Practice Address - Fax:707-648-9506
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41714OtherMFT