Provider Demographics
NPI:1316158504
Name:MATSO, CHRISTINA BIRGITTA (PHD , MFT)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:BIRGITTA
Last Name:MATSO
Suffix:
Gender:F
Credentials:PHD , MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 34
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2948
Mailing Address - Country:US
Mailing Address - Phone:310-545-1743
Mailing Address - Fax:310-796-1123
Practice Address - Street 1:2100 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 34
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2948
Practice Address - Country:US
Practice Address - Phone:310-545-1743
Practice Address - Fax:310-796-1123
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 23056106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist