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General NPI Number Information
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NPI Number | 1316158504
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Entity Type | Individual
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Provider Name | CHRISTINA BIRGITTA MATSO PH.D. , MFT
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Gender | Female
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Dates
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Enumeration Date | 05/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 N SEPULVEDA BLVD SUITE 34
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2948
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Country | US
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Telephone | 310-545-1743
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Fax | 310-796-1123
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Provider Business Mailing Address
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Address Line | 2100 N SEPULVEDA BLVD SUITE 34
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-2948
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Country | US
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Telephone | 310-545-1743
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Fax | 310-796-1123
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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 | MFT 23056
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License Number State | CA
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