Provider Demographics
NPI:1780294611
Name:JAIMES-CARACHURE, CRISTIAN
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:JAIMES-CARACHURE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 KENNEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2416
Mailing Address - Country:US
Mailing Address - Phone:562-338-7211
Mailing Address - Fax:
Practice Address - Street 1:444 W OCEAN BLVD FL 8
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4518
Practice Address - Country:US
Practice Address - Phone:562-661-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-24-74978103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst