Healthcare Provider Details

I. General information

NPI: 1386875581
Provider Name (Legal Business Name): MS. CHRISTINE CIPPERLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5890 NEWMAN CT
SACRAMENTO CA
95819-2608
US

IV. Provider business mailing address

5890 NEWMAN CT
SACRAMENTO CA
95819-2608
US

V. Phone/Fax

Practice location:
  • Phone: 916-452-7481
  • Fax: 916-736-0282
Mailing address:
  • Phone: 916-452-7481
  • Fax: 916-736-0282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: