Provider Demographics
NPI:1205958626
Name:ANASTASI, CHRISTINE KAY (CMPSS)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:ANASTASI
Suffix:
Gender:F
Credentials:CMPSS
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:KAY
Other - Last Name:ANASTASI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMPSS
Mailing Address - Street 1:52165 AVENIDA ALVARADO
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253
Mailing Address - Country:US
Mailing Address - Phone:760-832-2505
Mailing Address - Fax:
Practice Address - Street 1:44199 MONROE ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3096
Practice Address - Country:US
Practice Address - Phone:760-832-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-2YQXJI175T00000X, 172V00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker