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General NPI Number Information
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NPI Number | 1972161263
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Entity Type | Individual
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Provider Name | CRISTAL PULIDO MEJIA
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Gender | Female
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 236 GEORGIA ST STE 102
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City | VALLEJO
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State | CA
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Zip | 94590-5962
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Country | US
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Telephone | 707-552-2581
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Fax |
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Provider Business Mailing Address
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Address Line | 3941 MEADOWBROOK CIR
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City | PITTSBURG
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State | CA
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Zip | 94565-5539
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Country | US
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Telephone | 925-727-6680
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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 | CA
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