Provider Demographics
NPI:1780170597
Name:FLORES, CRISTINA G
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:G
Last Name:FLORES
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 1:147 EL DORADO AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-6255
Mailing Address - Country:US
Mailing Address - Phone:510-921-1119
Mailing Address - Fax:
Practice Address - Street 1:147 EL DORADO AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-6255
Practice Address - Country:US
Practice Address - Phone:510-921-1119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst