Basic Information
Provider Information
NPI: 1427183417
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VILLATORO
FirstName: CHRISTINA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MFC INTERN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10929 SOUTH ST
Address2: SUITE 208B
City: CERRITOS
State: CA
PostalCode: 907035340
CountryCode: US
TelephoneNumber: 5629245526
FaxNumber: 5629241040
Practice Location
Address1: 10929 SOUTH ST
Address2: SUITE 208B
City: CERRITOS
State: CA
PostalCode: 907035340
CountryCode: US
TelephoneNumber: 5629245526
FaxNumber: 5629241040
Other Information
ProviderEnumerationDate: 02/22/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XIMF49889CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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