Provider Demographics
NPI:1902937816
Name:WHITAKER, CHRISTAL-JOI (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTAL-JOI
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46E PENINSULA CENTER
Mailing Address - Street 2:#197
Mailing Address - City:ROLLING HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1384
Mailing Address - Country:US
Mailing Address - Phone:855-252-3022
Mailing Address - Fax:855-252-3022
Practice Address - Street 1:46E PENINSULA CENTER
Practice Address - Street 2:#197
Practice Address - City:ROLLING HILLS
Practice Address - State:CA
Practice Address - Zip Code:90274-9027
Practice Address - Country:US
Practice Address - Phone:855-252-3022
Practice Address - Fax:855-252-3022
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50270106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist