Provider Demographics
NPI:1053928838
Name:CRISTERNA, MYRNA (MFT)
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:
Last Name:CRISTERNA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1148
Mailing Address - Country:US
Mailing Address - Phone:323-691-6718
Mailing Address - Fax:
Practice Address - Street 1:2790 SKYPARK DR STE 205
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5345
Practice Address - Country:US
Practice Address - Phone:310-772-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist