Provider Demographics
NPI:1285893602
Name:KRISTO, CAROLINE Z (LMFT)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:Z
Last Name:KRISTO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:Z
Other - Last Name:KRISTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LMFT
Mailing Address - Street 1:370 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-3432
Mailing Address - Country:US
Mailing Address - Phone:707-464-4349
Mailing Address - Fax:707-464-4572
Practice Address - Street 1:29995 TECHNOLOGY DR STE 304
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2634
Practice Address - Country:US
Practice Address - Phone:951-923-4350
Practice Address - Fax:951-696-7292
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist