Provider Demographics
NPI:1497248231
Name:KORTENHOEVEN, CHRISTINE JENNIFER (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JENNIFER
Last Name:KORTENHOEVEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28693 OLD TOWN FRONT ST STE 300F
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2786
Mailing Address - Country:US
Mailing Address - Phone:951-249-3436
Mailing Address - Fax:
Practice Address - Street 1:28693 OLD TOWN FRONT ST STE 300F
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2786
Practice Address - Country:US
Practice Address - Phone:951-249-3436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT119289106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist