Provider Demographics
NPI:1558030452
Name:CHRISTENSEN, JAMES MORONI (LMFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MORONI
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HARDING BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2471
Mailing Address - Country:US
Mailing Address - Phone:916-292-8920
Mailing Address - Fax:
Practice Address - Street 1:300 HARDING BLVD STE 108
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2471
Practice Address - Country:US
Practice Address - Phone:916-292-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT142990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist