Basic Information
| Provider Information | |||||||||
| NPI: | 1427307016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMO | ||||||||
| FirstName: | KRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10012 NORWALK BLVD. STE. 110 | ||||||||
| Address2: | |||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629061335 | ||||||||
| FaxNumber: | 5629061315 | ||||||||
| Practice Location | |||||||||
| Address1: | 2457 ENDICOTT STREET | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232275252 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2012 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.