Provider Demographics
NPI:1841012473
Name:BARRERA-CIOTU, MARIA CRISTINA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CRISTINA
Last Name:BARRERA-CIOTU
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 1:7410 WOODMAN AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1524
Mailing Address - Country:US
Mailing Address - Phone:818-310-2698
Mailing Address - Fax:
Practice Address - Street 1:8550 BALBOA BLVD STE 242
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3593
Practice Address - Country:US
Practice Address - Phone:818-894-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52484225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant