Provider Demographics
NPI:1528931581
Name:DALTON, CHRISTINA GRACE (PPS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:GRACE
Last Name:DALTON
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-7212
Mailing Address - Country:US
Mailing Address - Phone:925-634-3521
Mailing Address - Fax:
Practice Address - Street 1:2244 TRINITY PL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-7212
Practice Address - Country:US
Practice Address - Phone:925-634-3521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250144674101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool