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General NPI Number Information
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NPI Number | 1588168405
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN RANNEY
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 10 4TH ST
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City | PETALUMA
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State | CA
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Zip | 94952-3004
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Country | US
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Telephone | 707-776-7042
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Fax |
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Provider Business Mailing Address
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Address Line | 113 ROUND CT
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City | PETALUMA
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State | CA
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Zip | 94952-4719
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Country | US
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Telephone | 707-776-7042
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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 | 23139
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License Number State | CA
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