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General NPI Number Information
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NPI Number | 1114394566
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Entity Type | Individual
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Provider Name | KRISTINA CUNEO
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Gender | Female
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 01/25/2019
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Provider Practice Location Address
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Address Line | 6762 LEXINGTON AVE STE A
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City | LOS ANGELES
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State | CA
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Zip | 90038
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Country | US
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Telephone | 857-302-2890
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Fax |
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Provider Business Mailing Address
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Address Line | 5226 LEXINGTON AVE APT 21
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City | LOS ANGELES
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State | CA
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Zip | 90029-1223
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Country | US
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Telephone | 617-794-7131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PCCI2151
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License Number State | CA
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