Provider Demographics
NPI:1295980811
Name:ROMER, CHRISTINE ERNEST (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ERNEST
Last Name:ROMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:ERNEST
Other - Last Name:ROMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 1351
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-1351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:269 SAGE SPARROW CIR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7751
Practice Address - Country:US
Practice Address - Phone:707-451-4111
Practice Address - Fax:707-451-9803
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW24620104100000X
CALCSW742161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker