Healthcare Provider Details

I. General information

NPI: 1710836713
Provider Name (Legal Business Name): CHRISTINE A VITALE LEP # 2726
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36825 FOOTHILL RD
SOLEDAD CA
93960-9656
US

IV. Provider business mailing address

1585 PRESCOTT AVE
MONTEREY CA
93940-1649
US

V. Phone/Fax

Practice location:
  • Phone: 831-678-3524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: