Provider Demographics
NPI:1497887319
Name:MICHAELS, KRISTIN C (MFT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:C
Last Name:MICHAELS
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 1:8801 FOLSOM BLVD STE 285
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3265
Mailing Address - Country:US
Mailing Address - Phone:415-519-7498
Mailing Address - Fax:
Practice Address - Street 1:8801 FOLSOM BLVD STE 285
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3265
Practice Address - Country:US
Practice Address - Phone:415-519-7498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52792106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist