Provider Demographics
NPI:1144368564
Name:SCHREADER, KRISTY LYNNE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LYNNE
Last Name:SCHREADER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 NAVAHO DR
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-2125
Mailing Address - Country:US
Mailing Address - Phone:916-609-4940
Mailing Address - Fax:916-609-5160
Practice Address - Street 1:5030 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4650
Practice Address - Country:US
Practice Address - Phone:916-609-4940
Practice Address - Fax:916-609-5160
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC#42534106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist