Provider Demographics
NPI:1235162041
Name:KRISTENSEN, KARIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:
Last Name:KRISTENSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4011
Mailing Address - Country:US
Mailing Address - Phone:619-281-9552
Mailing Address - Fax:
Practice Address - Street 1:3633 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4011
Practice Address - Country:US
Practice Address - Phone:619-281-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19524103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical