Provider Demographics
NPI:1972773968
Name:CRISOSTOMO-WEEKS, ARLEEN BALLAT
Entity Type:Individual
Prefix:DR
First Name:ARLEEN
Middle Name:BALLAT
Last Name:CRISOSTOMO-WEEKS
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 1:9844 HIBERT ST
Mailing Address - Street 2:SUITE G-7
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1000
Mailing Address - Country:US
Mailing Address - Phone:858-271-7440
Mailing Address - Fax:858-271-0180
Practice Address - Street 1:9844 HIBERT ST
Practice Address - Street 2:SUITE G-7
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1000
Practice Address - Country:US
Practice Address - Phone:858-271-7440
Practice Address - Fax:858-271-0180
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice