Provider Demographics
NPI:1154896561
Name:AREOLA, CRISTINA ACOSTA
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ACOSTA
Last Name:AREOLA
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 1:3950 BYRD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-1731
Mailing Address - Country:US
Mailing Address - Phone:619-690-1334
Mailing Address - Fax:619-428-4138
Practice Address - Street 1:3950 BYRD ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1731
Practice Address - Country:US
Practice Address - Phone:619-690-1334
Practice Address - Fax:619-428-4138
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool