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NPI Code Detail

MEDICARE: CHRISTINE BAIRSTOW LMFT

MEDICARE: CHRISTINE BAIRSTOW LMFT
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
1106H00000XMarriage & Family Therapist124560CA

General Provider Information

NPI Number : 1528652732
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE BAIRSTOW LMFT
Provider Business Mailing Address
First Line : 7252 ARCHIBALD AVE UNIT 578
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91701-5017
Country : US
Telephone Number : 760-282-9910
Fax Number :
Provider Business Practice Location Address
First Line : 11845 W OLYMPIC BLVD STE 1050W
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-5046
Country : US
Telephone Number : 424-330-2217
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2021
Last Update Date : 09/09/2025

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Directions to “ CHRISTINE BAIRSTOW LMFT” Practice Location

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