Provider Demographics
NPI:1386801223
Name:CRISTOBAL, HOPE A (PSYD)
Entity type:Individual
Prefix:DR
First Name:HOPE
Middle Name:A
Last Name:CRISTOBAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 CHALAN SAN ANTONIO
Mailing Address - Street 2:STE 105
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-649-2080
Mailing Address - Fax:671-649-2082
Practice Address - Street 1:472 CHALAN SAN ANTONIO
Practice Address - Street 2:STE 105
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-649-2080
Practice Address - Fax:671-649-2082
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
GUCP-35103TC0700X
CAPSY22485103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist