Provider Demographics
NPI:1114256351
Name:HOMER, CHRISTINA MARIE (CADC1, BSBM)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:HOMER
Suffix:
Gender:F
Credentials:CADC1, BSBM
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:VENABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6801 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-2143
Mailing Address - Country:US
Mailing Address - Phone:916-642-0290
Mailing Address - Fax:
Practice Address - Street 1:1200 FRANMOR CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3709
Practice Address - Country:US
Practice Address - Phone:916-642-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)