Provider Demographics
NPI:1578690491
Name:CAMPBELL, CHRISTIN ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:ANN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CRI
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2119 VAQUERO WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-5845
Mailing Address - Country:US
Mailing Address - Phone:916-622-1214
Mailing Address - Fax:
Practice Address - Street 1:1017 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4547
Practice Address - Country:US
Practice Address - Phone:707-647-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health