Provider Demographics
NPI:1871462077
Name:AGUIRRE, CRISTINA (MS)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16946 SHERMAN WAY # 100
Mailing Address - Street 2:
Mailing Address - City:LAKE BALBOA
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3613
Mailing Address - Country:US
Mailing Address - Phone:818-353-3772
Mailing Address - Fax:818-353-3776
Practice Address - Street 1:16946 SHERMAN WAY # 100
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-3613
Practice Address - Country:US
Practice Address - Phone:818-353-3772
Practice Address - Fax:818-353-3776
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12585433103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty