Individual
CHRISTINE ELIZABETH MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1465 30TH ST STE K, SAN DIEGO, CA 92154-3497
(619) 428-1000
Mailing address
1465 30TH ST STE K, SAN DIEGO, CA 92154-3497
(619) 428-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12916
CA
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
03/29/2022
Last updated
03/11/2026
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