Provider Demographics
NPI:1013501436
Name:MIRAMONTES, CRISTINA
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:
Last Name:MIRAMONTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E 4TH ST STE 116
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3916
Mailing Address - Country:US
Mailing Address - Phone:714-824-8150
Mailing Address - Fax:
Practice Address - Street 1:2001 E 4TH ST STE 116
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3916
Practice Address - Country:US
Practice Address - Phone:147-824-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114269104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker