Active NPI
Cristiane Stefani Bertuol, M.D.
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1861783821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A122038
- Practice address
- 1465 30TH Street
Suite K
San Diego, CA 92154-3497 - Phone
- (619) 428-1000
- Fax
- (619) 428-1091
- NPI assigned
- Apr 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A122038 | CA | Primary |
Addresses
Primary practice location
1465 30TH Street
Suite K
San Diego, CA 92154-3497
Mailing address
1465 30TH Street
Suite K
San Diego, CA 92154-3497
Phone (408) 806-0371
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122038 | CA | MD | Marriage & Family Therapist |
| A122038 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403568000000",
"number": "1861783821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 30TH STREET",
"address_2": "SUITE K",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921543497",
"telephone_number": "408-806-0371",
"fax_number": "619-428-1091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 30TH STREET",
"address_2": "SUITE K",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921543497",
"telephone_number": "619-428-1000",
"fax_number": "619-428-1091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTUOL",
"first_name": "CRISTIANE",
"middle_name": "STEFANI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-26",
"last_updated": "2014-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A122038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.