Provider Demographics
NPI:1598987620
Name:BRITTANY, CHRISTINA (MFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:BRITTANY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 DOCKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2290
Mailing Address - Country:US
Mailing Address - Phone:707-252-2023
Mailing Address - Fax:415-492-9303
Practice Address - Street 1:86 DOCKSIDE CIR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2290
Practice Address - Country:US
Practice Address - Phone:707-252-2023
Practice Address - Fax:415-492-9303
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT19329106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist