Provider Demographics
NPI:1528570108
Name:VILLANUEVA, CHRISTINA (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:VILLANUEVA
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 1:4423 77TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-3630
Mailing Address - Country:US
Mailing Address - Phone:916-718-6068
Mailing Address - Fax:
Practice Address - Street 1:2620 J ST STE 2
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4381
Practice Address - Country:US
Practice Address - Phone:916-803-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT102200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health