Provider Demographics
NPI:1023241080
Name:SERRANO, KRISTINA NICOLE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:NICOLE
Last Name:SERRANO
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 1:31 RHEEM BLVD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3618
Mailing Address - Country:US
Mailing Address - Phone:925-254-9111
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:SUITE 1277
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3099
Practice Address - Country:US
Practice Address - Phone:415-397-6622
Practice Address - Fax:415-397-6666
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT41435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist