Provider Demographics
NPI:1811072598
Name:CHASTAIN, CRISTINE D (LCSW)
Entity type:Individual
Prefix:
First Name:CRISTINE
Middle Name:D
Last Name:CHASTAIN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:CRISTINE
Other - Middle Name:C
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:23120 ALICIA PKWY STE 236
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1210
Mailing Address - Country:US
Mailing Address - Phone:949-235-2952
Mailing Address - Fax:801-494-2952
Practice Address - Street 1:23120 ALICIA PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1210
Practice Address - Country:US
Practice Address - Phone:949-235-2952
Practice Address - Fax:801-494-2952
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW216181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical