MEDICARE: CHRISTINE MARIE CRISOSTOMO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist		CA

General Provider Information

NPI Number	:	1114865292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MARIE CRISOSTOMO

Provider Business Mailing Address
First Line	:	1814 PAMELA LN
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-1029
Country	:	US
Telephone Number	:	760-419-3687
Fax Number	:

Provider Business Practice Location Address
First Line	:	1878 W EL NORTE PKWY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-3343
Country	:	US
Telephone Number	:	760-419-3687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ CHRISTINE MARIE CRISOSTOMO ” Practice Location

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