Provider Demographics
NPI:1013205004
Name:MEYER, CHRISTIAN DAVID (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:DAVID
Last Name:MEYER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NAPA VALLEJO HWY.
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6293
Mailing Address - Country:US
Mailing Address - Phone:707-253-5000
Mailing Address - Fax:707-253-5513
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650
Practice Address - Country:US
Practice Address - Phone:562-521-1489
Practice Address - Fax:562-651-5426
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2018-07-12
Deactivation Date:2011-09-20
Deactivation Code:
Reactivation Date:2015-08-07
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA26044103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst