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General NPI Number Information
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NPI Number | 1851444780
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Entity Type | Individual
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Provider Name | KRISTINA VENTURA MFT
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 E ALASKA AVE SUITE 9
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City | FAIRFIELD
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State | CA
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Zip | 94533
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Country | US
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Telephone | 707-644-0485
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Fax | 707-648-9506
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Provider Business Mailing Address
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Address Line | 123 VISTA HERMOSA
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City | WALNUT CREEK
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State | CA
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Zip | 94597-3948
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Country | US
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Telephone | 925-285-1866
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 41714
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License Number State | CA
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