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1013864669 NPI number — MISS CRISTINA MARIE RENTERIA

NPI Number: 1013864669
Health Care Provider/Practitioner: MISS CRISTINA MARIE RENTERIA

Information about “1013864669” NPI (MISS CRISTINA MARIE RENTERIA) exists in 1013864669 in HTML format HTML  |  1013864669 in plain Text format TXT  |  1013864669 in PDF (Portable Document Format) PDF  |  1013864669 in an XML format XML  formats.

NPI Number : 1013864669 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013864669",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RENTERIA",
    "FirstName": "CRISTINA",
    "MiddleName": "MARIE",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RENTERIA",
    "OtherFirstName": "STEVIE",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "996 ROYAL MARCO WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MARCO ISLAND",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34145-1829",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "31170 TEMECULA PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TEMECULA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92592-2914",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "951-699-8640",
    "PracticeLocationAddressFaxNumber": "951-225-4672",
    "EnumerationDate": "03/12/2026",
    "LastUpdateDate": "03/12/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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