Individual
MISS CRISTINA AMBOS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 HOLLY WAY, PISMO BEACH, CA 93449-3221
(805) 904-6592
(805) 904-6593
Mailing address
108 HOLLY WAY, PISMO BEACH, CA 93449-3221
(805) 904-6592
(805) 904-6593
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
405801964
CA
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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