Provider Demographics
NPI:1417288705
Name:CHRISTENSEN, BETH REED (M A, PPS, MFT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:REED
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:M A, PPS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 SANTA RITA RD STE 225
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4732
Mailing Address - Country:US
Mailing Address - Phone:925-699-3476
Mailing Address - Fax:
Practice Address - Street 1:1811 SANTA RITA RD STE 225
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4732
Practice Address - Country:US
Practice Address - Phone:925-699-3476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080112984101YS0200X
CAMFC43287106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool