Provider Demographics
NPI:1538936992
Name:ZIEHM, CHRISTINA (BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ZIEHM
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:VT
Mailing Address - Zip Code:05860-0269
Mailing Address - Country:US
Mailing Address - Phone:661-755-6178
Mailing Address - Fax:
Practice Address - Street 1:4456 MANZANITA AVE
Practice Address - Street 2:
Practice Address - City:CLEARLAKE
Practice Address - State:CA
Practice Address - Zip Code:95422-7200
Practice Address - Country:US
Practice Address - Phone:661-755-6178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-23-69910103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst