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General NPI Number Information
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NPI Number | 1578638516
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Entity Type | Individual
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Provider Name | GRETCHEN CHRISTIE MA
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Gender | Female
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1891 E ROSEVILLE PKWY SUITE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-7973
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Country | US
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Telephone | 916-789-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 BLACK OAK DR
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City | ROCKLIN
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State | CA
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Zip | 95765-4640
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Country | US
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Telephone | 916-435-3660
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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 | 36803
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License Number State | CA
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