Healthcare Provider Details

I. General information

NPI: 1316417488
Provider Name (Legal Business Name): CHRISTINA DINH MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 BRICKYARD COVE RD STE 111
POINT RICHMOND CA
94801-4112
US

IV. Provider business mailing address

1160 BRICKYARD COVE RD STE 111
POINT RICHMOND CA
94801-4112
US

V. Phone/Fax

Practice location:
  • Phone: 510-942-4600
  • Fax:
Mailing address:
  • Phone: 510-942-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: