Provider Demographics
NPI:1508494394
Name:ISRAEL, CHRISTY ANN (APPC)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANN
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:APPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35306 AZALEA LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8982
Mailing Address - Country:US
Mailing Address - Phone:714-878-3039
Mailing Address - Fax:
Practice Address - Street 1:3737 CAMINO DEL RIO S STE 302
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4009
Practice Address - Country:US
Practice Address - Phone:619-787-6676
Practice Address - Fax:619-243-3268
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional