Healthcare Provider Details

I. General information

NPI: 1114807906
Provider Name (Legal Business Name): CRISTINA GALLARDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 TRUXTUN AVE
BAKERSFIELD CA
93301-3133
US

IV. Provider business mailing address

3320 TRUXTUN AVE
BAKERSFIELD CA
93301-3133
US

V. Phone/Fax

Practice location:
  • Phone: 661-863-2302
  • Fax:
Mailing address:
  • Phone: 661-863-2302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number53928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: