Provider Demographics
NPI:1831675792
Name:STERLING, KRISTINA KIMBERLY (MS)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:KIMBERLY
Last Name:STERLING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 BAYSIDE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-7459
Mailing Address - Country:US
Mailing Address - Phone:925-639-6733
Mailing Address - Fax:
Practice Address - Street 1:2465 DOLAN WAY
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-1668
Practice Address - Country:US
Practice Address - Phone:510-221-6966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107339106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist