Healthcare Provider Details

I. General information

NPI: 1457145773
Provider Name (Legal Business Name): CRISTINA MARIA LIZARRAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 BROADWAY STE 1600
DENVER CO
80202-5160
US

IV. Provider business mailing address

1560 BROADWAY STE 1600
DENVER CO
80202-5160
US

V. Phone/Fax

Practice location:
  • Phone: 626-339-4999
  • Fax:
Mailing address:
  • Phone: 720-672-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-357557
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: