Healthcare Provider Details

I. General information

NPI: 1902925209
Provider Name (Legal Business Name): CHRISTINA LYNN HARLEY-BISHARA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CHRISTINA LYNN HARLEY

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W AVENUE J SUITE C
LANCASTER CA
93534-3443
US

IV. Provider business mailing address

19408 OLD FRIEND RD
SANTA CLARITA CA
91351-1273
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-0131
  • Fax:
Mailing address:
  • Phone: 818-512-8709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC47290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: