Healthcare Provider Details

I. General information

NPI: 1730016031
Provider Name (Legal Business Name): CRISTINA GONZALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 N OGDEN ST
DENVER CO
80218-1909
US

IV. Provider business mailing address

925 S MEADE ST
DENVER CO
80219-3340
US

V. Phone/Fax

Practice location:
  • Phone: 720-248-8338
  • Fax:
Mailing address:
  • Phone: 720-248-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0028169
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: