Basic Information
Provider Information
NPI: 1831108281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PANTER
FirstName: CHRISTY
MiddleName: PROPSTRA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 343 ARCARO LN
Address2:  
City: SOLANA BEACH
State: CA
PostalCode: 920752375
CountryCode: US
TelephoneNumber: 8582791223
FaxNumber:  
Practice Location
Address1: 505 LOMAS SANTA FE DR
Address2:  
City: SOLANA BEACH
State: CA
PostalCode: 920751333
CountryCode: US
TelephoneNumber: 8582791223
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X40232CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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