Provider Demographics
NPI:1912456377
Name:SLOAN, CRISTINA IVETTE (LPCC, LMFT)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:IVETTE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:LPCC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 VALE TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5218
Mailing Address - Country:US
Mailing Address - Phone:760-631-5000
Mailing Address - Fax:760-414-3892
Practice Address - Street 1:1000 VALE TERRACE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5218
Practice Address - Country:US
Practice Address - Phone:760-631-5000
Practice Address - Fax:760-414-3892
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2023-12-31
Deactivation Date:2022-12-22
Deactivation Code:
Reactivation Date:2023-04-28
Provider Licenses
StateLicense IDTaxonomies
CA9929101YM0800X
CA137279106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health