Healthcare Provider Details

I. General information

NPI: 1164579454
Provider Name (Legal Business Name): CHRISTINA KAY BJORNSTEDT MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 FIGUEROA ST
VENTURA CA
93001-2756
US

IV. Provider business mailing address

107 SOUTH FIGUEROA STREET
VENTURA CA
93001
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-0971
  • Fax:
Mailing address:
  • Phone: 805-652-0971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC21202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: