Provider Demographics
NPI:1699283747
Name:SCHULZ, CHRISTINA (BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:WATERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5075 SHOREHAM PL STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5927
Mailing Address - Country:US
Mailing Address - Phone:858-272-2662
Mailing Address - Fax:858-272-2661
Practice Address - Street 1:5075 SHOREHAM PL STE 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5927
Practice Address - Country:US
Practice Address - Phone:858-272-2662
Practice Address - Fax:858-272-2661
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-30694103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-18-30694OtherBACB