Provider Demographics
NPI:1114899838
Name:DELACRUZ, CRISTIAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:DELACRUZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 N EL CAMINO REAL # B-351
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1334
Mailing Address - Country:US
Mailing Address - Phone:619-501-9037
Mailing Address - Fax:619-501-9038
Practice Address - Street 1:4635 MISSION GORGE PL STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4145
Practice Address - Country:US
Practice Address - Phone:619-501-9037
Practice Address - Fax:619-501-9038
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty