Provider Demographics
NPI:1629269204
Name:MOJARRO, CRISTINA
Entity type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:MOJARRO
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 1:805 LANDSFORD ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2724
Mailing Address - Country:US
Mailing Address - Phone:323-394-2584
Mailing Address - Fax:
Practice Address - Street 1:44349 LOWTREE AVE STE 11
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4100
Practice Address - Country:US
Practice Address - Phone:661-228-0567
Practice Address - Fax:205-509-5337
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7420Medicaid
CA7068Medicaid