Basic Information
| Provider Information | |||||||||
| NPI: | 1992102255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POPE | ||||||||
| FirstName: | CHRYSTINA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PHD,ABD, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2539 BEL AIRE WAY | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897061103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054000248 | ||||||||
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| Practice Location | |||||||||
| Address1: | 162J GROVE ST | ||||||||
| Address2: | |||||||||
| City: | BISHOP | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935142640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608736533 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2014 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | N | Agencies | Community/Behavioral Health | 106H00000X | 82943 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.