Healthcare Provider Details

I. General information

NPI: 1730492646
Provider Name (Legal Business Name): CHRISTA WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 SAN MIGUEL DR STE 308B
WALNUT CREEK CA
94596-8604
US

IV. Provider business mailing address

1844 SAN MIGUEL DR STE 308B
WALNUT CREEK CA
94596-8604
US

V. Phone/Fax

Practice location:
  • Phone: 925-236-0048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number28717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: