Provider Demographics
NPI:1942973870
Name:DONCKELS, CHRISTA WHITNEY
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:WHITNEY
Last Name:DONCKELS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTA
Other - Middle Name:JANINE
Other - Last Name:WHITNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18650 ADALANTE CT
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-6312
Mailing Address - Country:US
Mailing Address - Phone:661-221-2625
Mailing Address - Fax:
Practice Address - Street 1:1601 NEW STINE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3696
Practice Address - Country:US
Practice Address - Phone:323-426-6402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66982355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant