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General NPI Number Information
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NPI Number | 1366027740
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Entity Type | Individual
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Provider Name | CRISTINA CHILGEVORKYAN
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Gender | Female
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Dates
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Enumeration Date | 03/16/2021
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 1025 ATLANTIC AVE STE 101
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City | ALAMEDA
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State | CA
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Zip | 94501-1188
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Country | US
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Telephone | 510-251-8120
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Fax |
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Provider Business Mailing Address
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Address Line | 244 W FAIRVIEW AVE APT 202
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City | GLENDALE
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State | CA
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Zip | 91202-2978
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Country | US
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Telephone | 818-220-1559
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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