Provider Demographics
NPI:1861827487
Name:TOLEDO, CHRISTINE
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:TOLEDO
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 1:222 W 6TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3332
Mailing Address - Country:US
Mailing Address - Phone:310-833-3135
Mailing Address - Fax:310-833-3572
Practice Address - Street 1:222 W 6TH ST STE 230
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3332
Practice Address - Country:US
Practice Address - Phone:310-833-3135
Practice Address - Fax:310-833-3572
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT98706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist