Provider Demographics
NPI:1306278395
Name:MENA, CHRISTINA GABRIELA (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:GABRIELA
Last Name:MENA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SAN JOSE DR STE 3E
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3508
Mailing Address - Country:US
Mailing Address - Phone:617-453-9505
Mailing Address - Fax:617-807-0958
Practice Address - Street 1:8 SAN JOSE DR STE 3E
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3508
Practice Address - Country:US
Practice Address - Phone:757-657-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006742103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical