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NPI Code Detail

MEDICARE: CRISTINA ELENA BUSTOS PH.D.

MEDICARE:   CRISTINA ELENA BUSTOS  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist25308CA

General Provider Information

NPI Number : 1255771135
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTINA ELENA BUSTOS PH.D.
Provider Business Mailing Address
First Line : PO BOX 5362
Second Line :
City : OCEANSIDE
State : CA
Zip : 92052-5362
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3350 LA JOLLA VILLAGE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92161-6641
Country : US
Telephone Number : 760-643-2022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2013
Last Update Date : 03/11/2025

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Directions to “ CRISTINA ELENA BUSTOS PH.D.” Practice Location

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