Healthcare Provider Details

I. General information

NPI: 1568942258
Provider Name (Legal Business Name): CHRISTINE ANNE HARRINGTON LMFT, LIC. #88813
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

25 ROLLING OAKS DR STE 208
THOUSAND OAKS CA
91361-1009
US

IV. Provider business mailing address

1332 UPPINGHAM DR
THOUSAND OAKS CA
91360-6540
US

V. Phone/Fax

Practice location:
  • Phone: 805-630-3599
  • Fax:
Mailing address:
  • Phone: 805-630-3599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: