Provider Demographics
NPI:1497779912
Name:PARKER, CHRISTAN ELISE (MFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTAN
Middle Name:ELISE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4095 BRIDGE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7116
Mailing Address - Country:US
Mailing Address - Phone:916-974-1344
Mailing Address - Fax:
Practice Address - Street 1:4095 BRIDGE ST
Practice Address - Street 2:SUITE A
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7116
Practice Address - Country:US
Practice Address - Phone:916-974-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT40938101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health