Provider Demographics
NPI:1235510363
Name:OLIVIERI, CHRISTINA (MFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:OLIVIERI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:CK
Other - Middle Name:OLIVIERI
Other - Last Name:BLACKMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:889 PERALTA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-6241
Mailing Address - Country:US
Mailing Address - Phone:415-496-5092
Mailing Address - Fax:
Practice Address - Street 1:3150 18TH ST # 257
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2074
Practice Address - Country:US
Practice Address - Phone:415-496-5092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health