Healthcare Provider Details

I. General information

NPI: 1154829836
Provider Name (Legal Business Name): CHRISTINA SUNTHONLAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8912 VOLUNTEER LN
SACRAMENTO CA
95826-3221
US

IV. Provider business mailing address

4970 7TH AVE
SACRAMENTO CA
95820-1507
US

V. Phone/Fax

Practice location:
  • Phone: 916-344-0199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC14393
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1728996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: