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NPI Code Detail

MEDICARE: CHRISTY MICHELLE POTTER APCC

MEDICARE: CHRISTY MICHELLE POTTER APCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor7390CA
2101YP2500XProfessional Counselor19195CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
198399251C63319OTHERCAHMO

General Provider Information

NPI Number : 1164053393
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY MICHELLE POTTER APCC
Provider Business Mailing Address
First Line : 3333 14TH ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3858
Country : US
Telephone Number : 951-924-9791
Fax Number :
Provider Business Practice Location Address
First Line : 3333 14TH ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3858
Country : US
Telephone Number : 951-924-9791
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2020
Last Update Date : 08/26/2025

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Directions to “ CHRISTY MICHELLE POTTER APCC” Practice Location

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