Provider Demographics
NPI:1053506360
Name:SHELTON, CHRISTINE ANITA (MFT 38626 CA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANITA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MFT 38626 CA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANITA
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:10378 CAREY DR
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-4801
Mailing Address - Country:US
Mailing Address - Phone:530-272-0995
Mailing Address - Fax:530-273-1299
Practice Address - Street 1:405 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6403
Practice Address - Country:US
Practice Address - Phone:530-272-0995
Practice Address - Fax:530-273-1299
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 38626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health