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General NPI Number Information
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NPI Number | 1053634303
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Entity Type | Individual
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Provider Name | CHRISTINE PALMQUIST MARSHALL LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 11770 BERNARDO PLAZA CT STE 208
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City | SAN DIEGO
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State | CA
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Zip | 92128-2424
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Country | US
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Telephone | 858-822-9093
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Fax |
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Provider Business Mailing Address
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Address Line | 11835 CARMEL MOUNTAIN RD # 1304-214
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City | SAN DIEGO
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State | CA
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Zip | 92128-4609
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Country | US
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Telephone | 858-822-9093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 87418
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License Number State | CA
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