MEDICARE: SIERRA CHRISTY

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
1	221700000X	Art Therapist	23-481	CA
2	106H00000X	Marriage & Family Therapist	148735	CA

General Provider Information

NPI Number	:	1194551598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA CHRISTY

Provider Business Mailing Address
First Line	:	8432 BENJAMIN DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-7005
Country	:	US
Telephone Number	:	714-519-5402
Fax Number	:

Provider Business Practice Location Address
First Line	:	16052 BEACH BLVD STE 212
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-3852
Country	:	US
Telephone Number	:	714-519-5402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2024
Last Update Date	:	09/11/2024

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Directions to “ SIERRA CHRISTY ” Practice Location

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