Provider Demographics
NPI:1134311012
Name:HAWS, KRISTA MICHELLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MICHELLE
Last Name:HAWS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KRISTA
Other - Middle Name:MICHELLE
Other - Last Name:HAWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:14049 BOYS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SLOUGHHOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95683-9782
Mailing Address - Country:US
Mailing Address - Phone:916-355-8887
Mailing Address - Fax:
Practice Address - Street 1:14049 BOYS RANCH RD
Practice Address - Street 2:
Practice Address - City:SLOUGHHOUSE
Practice Address - State:CA
Practice Address - Zip Code:95683-9782
Practice Address - Country:US
Practice Address - Phone:916-355-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47704106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist