Provider Demographics
NPI:1285236893
Name:SANTAMARIA, CRISTINA BERNICE
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:BERNICE
Last Name:SANTAMARIA
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 1:309 S POLK
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75833-1791
Mailing Address - Country:US
Mailing Address - Phone:936-333-0930
Mailing Address - Fax:
Practice Address - Street 1:700 UNIVERSITY DR E STE 106
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-1848
Practice Address - Country:US
Practice Address - Phone:979-258-6406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician