Healthcare Provider Details

I. General information

NPI: 1356287817
Provider Name (Legal Business Name): CRISTELA SAMANIEGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 BRODER BLVD
DUBLIN CA
94568-3309
US

IV. Provider business mailing address

3695 STEVENSON BLVD # E314
FREMONT CA
94538-2371
US

V. Phone/Fax

Practice location:
  • Phone: 925-551-6500
  • Fax:
Mailing address:
  • Phone: 559-719-7974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: