Provider Demographics
NPI:1861617334
Name:FIELD, CHRISTINE (MFC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8839 N CEDAR AVE # 125
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1832
Mailing Address - Country:US
Mailing Address - Phone:559-246-6203
Mailing Address - Fax:
Practice Address - Street 1:8839 N CEDAR AVE # 125
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1832
Practice Address - Country:US
Practice Address - Phone:559-246-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42385106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA160101904300Medicaid