Healthcare Provider Details

I. General information

NPI: 1346834512
Provider Name (Legal Business Name): CRISTINA PAULA MOLDOVAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12291 WASHINGTON BLVD STE 300
WHITTIER CA
90606-2549
US

IV. Provider business mailing address

12291 WASHINGTON BLVD STE 300
WHITTIER CA
90606-2549
US

V. Phone/Fax

Practice location:
  • Phone: 562-967-2840
  • Fax:
Mailing address:
  • Phone: 562-967-2840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number32337
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: