Provider Demographics
NPI:1699806794
Name:ROMERO, CHRISTIAN L (MA)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:L
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:L
Other - Last Name:REINOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5230
Mailing Address - Country:US
Mailing Address - Phone:909-421-9435
Mailing Address - Fax:909-421-9439
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5230
Practice Address - Country:US
Practice Address - Phone:909-421-5617
Practice Address - Fax:909-421-9439
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53592106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist