Provider Demographics
NPI:1437361912
Name:GIETZEN-HARADEN, CHRISTINA LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LYNN
Last Name:GIETZEN-HARADEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7710 BALBOA AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2261
Mailing Address - Country:US
Mailing Address - Phone:858-232-9145
Mailing Address - Fax:858-278-1676
Practice Address - Street 1:7710 BALBOA AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2261
Practice Address - Country:US
Practice Address - Phone:858-232-9145
Practice Address - Fax:858-278-1676
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY17856103TA0400X, 103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral