Individual provider Active NPI

Cristine Elizabeth Bruzzone, PHD

  • Psychologist
  • Torrance, CA
National Provider Identifier
1073801544
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY34168 Issued in CA
Practice address
2790 Skypark Dr Ste 205
Torrance, CA 90505-5345
Phone
(310) 855-3990
Fax
(424) 276-7676
NPI assigned
Jul 18, 2011
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X RPS2012825 CA
Psychologist 103T00000X PSY34168 CA Primary

Addresses

Primary practice location

2790 Skypark Dr Ste 205
Torrance, CA 90505-5345

Mailing address

46 Peninsula Ctr Ste 379E
Rolling Hills Estates, CA 90274-3509
Phone (310) 855-3990

Other practice location 1

3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 836-1223

Other practice location 2

5535 Balboa Blvd Ste 110
Encino, CA 91316-1524
Phone (310) 855-3990 ext. 3

Other names 1

  • Miss Cristine Elizabeth Boyaggi Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY34168CAMDPsychologist
RPS2012825CAMDRehabilitation Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Accent on Wellness Psychology Associates, Inc. Psychologist PastSince Apr 30, 2023 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1073801544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 PENINSULA CTR STE 379E",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743509",
            "telephone_number": "310-855-3990",
            "fax_number": "424-276-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 SKYPARK DR STE 205",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055345",
            "telephone_number": "310-855-3990",
            "fax_number": "424-276-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Motor Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900343710",
            "country_code": "US",
            "telephone_number": "310-836-1223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5535 Balboa Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "913161524",
            "country_code": "US",
            "telephone_number": "310-855-3990 x3",
            "fax_number": "424-276-7676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUZZONE",
        "first_name": "CRISTINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": "RPS2012825",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY34168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINE",
            "last_name": "BOYAGGI",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.