Provider Demographics
NPI:1184972895
Name:VASQUEZ, CHRISTINA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 N CHERRY AVE PO BOX 210572
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-1134
Mailing Address - Country:US
Mailing Address - Phone:520-626-2982
Mailing Address - Fax:520-626-2525
Practice Address - Street 1:1335 N CHERRY AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-1134
Practice Address - Country:US
Practice Address - Phone:520-626-2982
Practice Address - Fax:520-626-2525
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4306103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist