Individual provider Active NPI

Cristina Vazquez

  • Marriage & Family Therapist
  • Bremerton, WA
National Provider Identifier
1780194209
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61441380 Issued in WA
Practice address
7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242
Phone
(360) 698-9258
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF61441380 WA Primary
Other Technician 247200000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242

Mailing address

7500 Old Military Rd NE Ste 103
Bremerton, WA 98311-3242
Phone (360) 698-9258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501001796 WA Practitioner - Marriage and Family Therapist 5597105098 Practice locations: Bremerton, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LF61441380WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cristina Vazquez Marriage & Family Therapist CurrentSince Apr 16, 2024 Accepting new patients
Center for Child and Family Therapy PC Inc Marriage & Family Therapist Current Accepting new patients
Youth Eastside Services PastSince Aug 1, 2019 Accepting new patients

Locations

7500 Old Military Rd NE
Ste 103
Bremerton, WA 98311
Phone (360) 698-9258

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1780194209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 OLD MILITARY RD NE STE 103",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113242",
            "telephone_number": "360-698-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 OLD MILITARY RD NE STE 103",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113242",
            "telephone_number": "360-698-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "CRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61441380",
            "primary": true
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.