Provider Demographics
NPI:1184013492
Name:BEARD, CHRISTINE (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:BINION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:163 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3316
Mailing Address - Country:US
Mailing Address - Phone:707-706-0113
Mailing Address - Fax:530-668-9194
Practice Address - Street 1:163 2ND ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3316
Practice Address - Country:US
Practice Address - Phone:707-706-0113
Practice Address - Fax:530-668-9194
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 70894106H00000X
CA96986106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist