Provider Demographics
NPI:1518981901
Name:BASHORE, KRISTI ANN (MFT, INTERN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:BASHORE
Suffix:
Gender:F
Credentials:MFT, INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9837 FOLSOM BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1356
Mailing Address - Country:US
Mailing Address - Phone:916-856-5700
Mailing Address - Fax:916-856-5708
Practice Address - Street 1:9837 FOLSOM BLVD STE F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-856-5700
Practice Address - Fax:916-856-5708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43544106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist