Provider Demographics
NPI:1629319215
Name:TOWNER, KRISTINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:
Last Name:TOWNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MCSP, 4001 HWY 104, PO BOX 409099
Mailing Address - Street 2:ATTN: MENTAL HEALTH SERVICES DEPARTMENT
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640
Mailing Address - Country:US
Mailing Address - Phone:209-274-4911
Mailing Address - Fax:
Practice Address - Street 1:MCSP, 4001 HWY 104
Practice Address - Street 2:ATTN: MENTAL HEALTH SERVICES DEPARTMENT
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640
Practice Address - Country:US
Practice Address - Phone:209-274-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS196951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical