Provider Demographics
NPI:1568695377
Name:BENNETT, CHRISTINA JOANN (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JOANN
Last Name:BENNETT
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 1:1485 TREAT BLVD
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-7995
Mailing Address - Country:US
Mailing Address - Phone:925-942-0733
Mailing Address - Fax:925-942-0735
Practice Address - Street 1:1485 TREAT BLVD
Practice Address - Street 2:SUITE 203B
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-7995
Practice Address - Country:US
Practice Address - Phone:925-942-0733
Practice Address - Fax:925-942-0735
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist