Healthcare Provider Details

I. General information

NPI: 1700560331
Provider Name (Legal Business Name): CHRISTINA MARIE PAIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4617 9TH ST
RIVERSIDE CA
92501-3020
US

IV. Provider business mailing address

4617 9TH ST
RIVERSIDE CA
92501-3020
US

V. Phone/Fax

Practice location:
  • Phone: 909-292-3187
  • Fax:
Mailing address:
  • Phone: 909-292-3187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: