Provider Demographics
NPI:1700915329
Name:ISLAS-BANTHI, MARIA CRISTINA
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:CRISTINA
Last Name:ISLAS-BANTHI
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 1:1599 HAYS ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4401
Mailing Address - Country:US
Mailing Address - Phone:510-552-7579
Mailing Address - Fax:
Practice Address - Street 1:474 VALENCIA ST STE 135
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3415
Practice Address - Country:US
Practice Address - Phone:415-864-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)