Provider Demographics
NPI:1336262690
Name:VENTO, CHRISTINA ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:VENTO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:VENTO
Other - Last Name:FAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9652 SUN DANCER DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6089
Mailing Address - Country:US
Mailing Address - Phone:505-238-5897
Mailing Address - Fax:505-248-7779
Practice Address - Street 1:9301 INDIAN SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2884
Practice Address - Country:US
Practice Address - Phone:505-218-6383
Practice Address - Fax:505-636-6338
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0789103TC0700X
NM0016103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18677037Medicaid
NM89550838Medicaid