Provider Demographics
NPI:1265893556
Name:RICHTER, CHRISTINA
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:RICHTER
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 1:2677 ORANGE AVE APT A2
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4695
Mailing Address - Country:US
Mailing Address - Phone:949-293-5707
Mailing Address - Fax:
Practice Address - Street 1:217 W CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6549
Practice Address - Country:US
Practice Address - Phone:714-776-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist