Provider Demographics
NPI:1952743304
Name:WAFER, CHRISTINA DAWN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:DAWN
Last Name:WAFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 N COAST HIGHWAY 101 SPC 50
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1042
Mailing Address - Country:US
Mailing Address - Phone:858-997-5535
Mailing Address - Fax:
Practice Address - Street 1:1624 N COAST HIGHWAY 101 SPC 50
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1042
Practice Address - Country:US
Practice Address - Phone:858-997-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IDPSY203419103TC0700X
HIPSY1964103TC0700X
CAPSY32287103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health