Healthcare Provider Details

I. General information

NPI: 1093199671
Provider Name (Legal Business Name): CRISTIANA SALUCCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8025 LINCOLN ST
LEMON GROVE CA
91945-2515
US

IV. Provider business mailing address

8025 LINCOLN ST
LEMON GROVE CA
91945-2515
US

V. Phone/Fax

Practice location:
  • Phone: 619-825-5600
  • Fax:
Mailing address:
  • Phone: 619-825-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101293
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: