Healthcare Provider Details

I. General information

NPI: 1396809802
Provider Name (Legal Business Name): CHRISTINE M MAYERCHAK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 LIBERTY ST
REDDING CA
96001-0848
US

IV. Provider business mailing address

1441 LIBERTY ST
REDDING CA
96001-0848
US

V. Phone/Fax

Practice location:
  • Phone: 530-226-1753
  • Fax: 530-224-2723
Mailing address:
  • Phone: 530-226-1753
  • Fax: 530-224-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: