Healthcare Provider Details

I. General information

NPI: 1366352122
Provider Name (Legal Business Name): CRISTINA E BUTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA E PEREZ

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 AVENIDA PICO STE 201
SAN CLEMENTE CA
92673-6356
US

IV. Provider business mailing address

1031 AVENIDA PICO STE 201
SAN CLEMENTE CA
92673-6356
US

V. Phone/Fax

Practice location:
  • Phone: 949-388-8788
  • Fax: 949-388-0829
Mailing address:
  • Phone: 949-388-8788
  • Fax: 949-388-0829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: