Provider Demographics
NPI:1891347811
Name:ZACHA, CHRISTINE LEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LEE
Last Name:ZACHA
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 1:4546 N ISLE ROYALE ST
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2151
Mailing Address - Country:US
Mailing Address - Phone:818-517-7336
Mailing Address - Fax:
Practice Address - Street 1:4546 N ISLE ROYALE ST
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2151
Practice Address - Country:US
Practice Address - Phone:818-517-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48609103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling