Provider Demographics
NPI:1245696103
Name:PERKINS, CRISTINA AZEVEDO (LMFT)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:AZEVEDO
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:AZEVEDO
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:132 N AKERS ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5121
Mailing Address - Country:US
Mailing Address - Phone:559-202-0380
Mailing Address - Fax:
Practice Address - Street 1:132 N AKERS ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5121
Practice Address - Country:US
Practice Address - Phone:559-202-0380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139699106H00000X, 106H00000X
CAIMF108185106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist