Provider Demographics
NPI:1689728081
Name:LUDWIGSEN, KRISTINA RAHBEK (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:RAHBEK
Last Name:LUDWIGSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2213 BUCHANAN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4265
Mailing Address - Country:US
Mailing Address - Phone:925-779-4930
Mailing Address - Fax:925-779-4963
Practice Address - Street 1:2213 BUCHANAN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4265
Practice Address - Country:US
Practice Address - Phone:925-779-4930
Practice Address - Fax:925-779-4963
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 9122103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist