Provider Demographics
NPI:1629134267
Name:CHRISTY, AMY (MA PSR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:MA PSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1666 GARNET AVE # 409
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3116
Mailing Address - Country:US
Mailing Address - Phone:619-235-2600
Mailing Address - Fax:619-696-9573
Practice Address - Street 1:1666 GARNET AVE # 409
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3116
Practice Address - Country:US
Practice Address - Phone:619-235-2600
Practice Address - Fax:619-696-9573
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health