Provider Demographics
NPI:1811408032
Name:PLATENKAMP, CHRISTINA JANNY (APCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JANNY
Last Name:PLATENKAMP
Suffix:
Gender:F
Credentials:APCC
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 15113
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95851-0113
Mailing Address - Country:US
Mailing Address - Phone:530-554-2677
Mailing Address - Fax:
Practice Address - Street 1:2020 5TH ST UNIT 2322
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95617-7100
Practice Address - Country:US
Practice Address - Phone:530-554-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-15
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC11622101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health