Provider Demographics
NPI:1790508448
Name:CHRISTY MERRINER FAMILY PSYCHOTHERAPY, P.C.
Entity type:Organization
Organization Name:CHRISTY MERRINER FAMILY PSYCHOTHERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MERRINER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:917-664-9940
Mailing Address - Street 1:249 AVENIDA MONTALVO APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4463
Mailing Address - Country:US
Mailing Address - Phone:917-664-9940
Mailing Address - Fax:
Practice Address - Street 1:5478 WILSHIRE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4225
Practice Address - Country:US
Practice Address - Phone:323-250-2482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTY MERRINER FAMILY PSYCHOTHERAPY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty