Provider Demographics
NPI:1134431950
Name:KEE, CHRISTINA MELISSA (MS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MELISSA
Last Name:KEE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:MELISSA
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1200 N. MAIN ST.
Mailing Address - Street 2:#500
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701
Mailing Address - Country:US
Mailing Address - Phone:714-480-6600
Mailing Address - Fax:
Practice Address - Street 1:21250 BOX SPRINGS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-8705
Practice Address - Country:US
Practice Address - Phone:951-369-8036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62847106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist