Provider Demographics
NPI:1346838646
Name:NETHERTON, KRISTINA C (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:C
Last Name:NETHERTON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 PRAIRIE CITY RD # 130-330
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-9595
Mailing Address - Country:US
Mailing Address - Phone:858-381-7511
Mailing Address - Fax:
Practice Address - Street 1:2775 KING EDWARD DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4109
Practice Address - Country:US
Practice Address - Phone:858-381-7511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist