Provider Demographics
NPI:1104016492
Name:SPINDA, CHRISTINE ANN
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:SPINDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SUNNYHILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1909
Mailing Address - Country:US
Mailing Address - Phone:916-509-0021
Mailing Address - Fax:916-509-0021
Practice Address - Street 1:300 SUNNYHILLS DR
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1909
Practice Address - Country:US
Practice Address - Phone:916-509-0021
Practice Address - Fax:916-509-0021
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 49126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist