Healthcare Provider Details

I. General information

NPI: 1306531975
Provider Name (Legal Business Name): CHRISTINA FELONIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 BALBOA AVE STE 205
SAN DIEGO CA
92117-6995
US

IV. Provider business mailing address

5252 BALBOA AVE STE 205
SAN DIEGO CA
92117-6995
US

V. Phone/Fax

Practice location:
  • Phone: 619-880-0485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: