Provider Demographics
NPI:1518796739
Name:NIELEPKO, CHRISTINE (LMFT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:NIELEPKO
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 1:5706 CAHALAN AVE # 23592
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3008
Mailing Address - Country:US
Mailing Address - Phone:408-800-2143
Mailing Address - Fax:
Practice Address - Street 1:5706 CAHALAN AVE # 23592
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3008
Practice Address - Country:US
Practice Address - Phone:408-800-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist