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NPI Code Detail

MEDICARE: CHRISTIN CONKLE

MEDICARE: CHRISTIN CONKLE
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 Therapist81036CA

General Provider Information

NPI Number : 1790971158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIN CONKLE
Provider Business Mailing Address
First Line : 4510 EXECUTIVE DR STE 315
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3029
Country : US
Telephone Number : 858-212-1831
Fax Number :
Provider Business Practice Location Address
First Line : 4510 EXECUTIVE DR STE 315
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3029
Country : US
Telephone Number : 858-212-1831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2007
Last Update Date : 12/15/2025

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Directions to “ CHRISTIN CONKLE ” Practice Location

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