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General NPI Number Information
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NPI Number | 1780294611
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Entity Type | Individual
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Provider Name | CRISTIAN JAIMES-CARACHURE
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Gender | Male
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 444 W OCEAN BLVD FL 8
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City | LONG BEACH
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State | CA
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Zip | 90802-4518
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Country | US
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Telephone | 562-661-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 42 KENNEBEC AVE
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City | LONG BEACH
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State | CA
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Zip | 90803-2416
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Country | US
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Telephone | 562-338-7211
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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 | 1-24-74978
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License Number State | CA
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