Provider Demographics
NPI:1609135979
Name:BUMA, CHRISTINE IRENE (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:IRENE
Last Name:BUMA
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:PO BOX 6502
Mailing Address - Street 2:
Mailing Address - City:PINE MOUNTAIN CLUB
Mailing Address - State:CA
Mailing Address - Zip Code:93222-6502
Mailing Address - Country:US
Mailing Address - Phone:562-397-5733
Mailing Address - Fax:
Practice Address - Street 1:1528 LINDEN DR
Practice Address - Street 2:
Practice Address - City:PINE MOUNTAIN CLUB
Practice Address - State:CA
Practice Address - Zip Code:93222-6502
Practice Address - Country:US
Practice Address - Phone:562-397-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 37957106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist