Provider Demographics
NPI:1760788673
Name:GEORGE, CHRISTY ANNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:ANNE
Last Name:GEORGE
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 1:11858 BERNARDO PLAZA CT
Mailing Address - Street 2:210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2439
Mailing Address - Country:US
Mailing Address - Phone:760-410-8186
Mailing Address - Fax:858-592-1495
Practice Address - Street 1:11858 BERNARDO PLAZA CT
Practice Address - Street 2:210
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2439
Practice Address - Country:US
Practice Address - Phone:760-410-8186
Practice Address - Fax:858-592-1495
Is Sole Proprietor?:No
Enumeration Date:2011-02-10
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA69438106H00000X
CA85531106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health