Individual provider Active NPI

Cristina Maria Perez, LMFT

  • Marriage & Family Therapist
  • San Gabriel, CA
National Provider Identifier
1033497334
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
90544 Issued in CA
Practice address
425 W Valley Blvd Ste 104-253
San Gabriel, CA 91776-5707
Phone
(818) 536-9002
NPI assigned
Aug 3, 2011
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 90544 CA Primary

Addresses

Primary practice location

425 W Valley Blvd Ste 104-253
San Gabriel, CA 91776-5707

Mailing address

425 W Valley Blvd Ste 104-253
San Gabriel, CA 91776-5707
Phone (818) 536-9002

Other identifiers 4

IdentifierTypeStateIssuer
7368OtherCAMEDI-CAL
7708OtherCAMEDI-CAL
7184OtherCAMEDI-CAL
7667OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90544CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
C&S Child, Adult, and Family Therapy Services Corporation Marriage & Family Therapist CurrentSince Jan 7, 2024 Accepting new patients

Locations

252 W Fairview Ave
San Gabriel, CA 91776

425 W Valley Blvd
Ste 104253
San Gabriel, CA 91776
Phone (818) 536-9002

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1033497334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W VALLEY BLVD STE 104-253",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765707",
            "telephone_number": "818-536-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W VALLEY BLVD STE 104-253",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917765707",
            "telephone_number": "818-536-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CRISTINA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "90544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.