Provider Demographics
NPI:1093277683
Name:ALLAN, CHRISTIE LYNNE (LMFT)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LYNNE
Last Name:ALLAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:LYNNE
Other - Last Name:MILLER-VICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3092 SUMATRA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5846
Mailing Address - Country:US
Mailing Address - Phone:707-688-6194
Mailing Address - Fax:
Practice Address - Street 1:2101 COURAGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6717
Practice Address - Country:US
Practice Address - Phone:707-784-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist