Provider Demographics
NPI:1083388821
Name:PAULSEN, CHRISTINE MELISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MELISSA
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S MONTCLAIR ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3111
Mailing Address - Country:US
Mailing Address - Phone:661-330-8375
Mailing Address - Fax:
Practice Address - Street 1:110 S MONTCLAIR ST STE 206
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3111
Practice Address - Country:US
Practice Address - Phone:661-330-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9992-C1041C0700X
CALCSW1012091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical