Provider Demographics
NPI:1265163075
Name:PALUMBO, CHRISTINE I (AMFT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:PALUMBO
Suffix:I
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3581
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92654-3581
Mailing Address - Country:US
Mailing Address - Phone:270-315-0225
Mailing Address - Fax:
Practice Address - Street 1:4701 VON KARMAN AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2161
Practice Address - Country:US
Practice Address - Phone:270-315-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117722103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical