Healthcare Provider Details

I. General information

NPI: 1205906146
Provider Name (Legal Business Name): CHRISTOPHER PATRICK CARNEY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 E PACIFIC COAST HWY SUITE 100
LONG BEACH CA
90804-3312
US

IV. Provider business mailing address

5150 E PACIFIC COAST HWY SUITE 100
LONG BEACH CA
90804-3312
US

V. Phone/Fax

Practice location:
  • Phone: 562-490-7600
  • Fax: 562-490-7601
Mailing address:
  • Phone: 562-490-7600
  • Fax: 562-490-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT44250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: