Provider Demographics
NPI:1932711918
Name:VLASIS, CHRISTINA DIANE (LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DIANE
Last Name:VLASIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7839 UNIVERSITY AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0478
Mailing Address - Country:US
Mailing Address - Phone:619-609-9182
Mailing Address - Fax:619-303-3671
Practice Address - Street 1:7839 UNIVERSITY AVE STE 106
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0478
Practice Address - Country:US
Practice Address - Phone:619-609-9182
Practice Address - Fax:619-303-3671
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist