Provider Demographics
NPI:1437880580
Name:MYERS, CHRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 COLUSA HWY STE C
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-9147
Mailing Address - Country:US
Mailing Address - Phone:530-618-8152
Mailing Address - Fax:530-618-8031
Practice Address - Street 1:1352 COLUSA HWY STE C
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-9147
Practice Address - Country:US
Practice Address - Phone:530-618-8178
Practice Address - Fax:530-618-8031
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03990315101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)