Individual
CRISTINA TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
200 MINOR HALL, BERKELEY, CA 94720-0001
(510) 642-2020
Mailing address
13681 HAVENWOOD DR, GARDEN GROVE, CA 92843-3557
(714) 234-4692
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
34304TLG
CA
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
34304TLG
CA
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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