Provider Demographics
NPI:1386923662
Name:GRISHAM, CRISTINA ARANDA (MA)
Entity type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:ARANDA
Last Name:GRISHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:TERESA
Other - Last Name:ROCHA GRISHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2688 OCEAN ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2237
Mailing Address - Country:US
Mailing Address - Phone:760-805-3015
Mailing Address - Fax:
Practice Address - Street 1:3990 OLD TOWN AVE
Practice Address - Street 2:BLDG. C, SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2930
Practice Address - Country:US
Practice Address - Phone:619-278-2400
Practice Address - Fax:619-294-9405
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor