Provider Demographics
NPI:1326248212
Name:WAHLER, CHRESTINA NAOMI (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRESTINA
Middle Name:NAOMI
Last Name:WAHLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5230 CARROLL CANYON RD STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1781
Mailing Address - Country:US
Mailing Address - Phone:858-254-9986
Mailing Address - Fax:844-584-3546
Practice Address - Street 1:10174 OLD GROVE RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1648
Practice Address - Country:US
Practice Address - Phone:858-254-9986
Practice Address - Fax:844-584-3546
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28017103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical