Provider Demographics
NPI:1649642240
Name:RESTIVO, CHRISTOPHER (MFT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:RESTIVO
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GOUGH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5971
Mailing Address - Country:US
Mailing Address - Phone:415-494-9848
Mailing Address - Fax:
Practice Address - Street 1:110 GOUGH ST STE 403
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5971
Practice Address - Country:US
Practice Address - Phone:415-494-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 88752106H00000X
CA103275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist