Provider Demographics
NPI:1912913104
Name:FRICK, CHRISTINE G (MS, MFT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:G
Last Name:FRICK
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20284 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4312
Mailing Address - Country:US
Mailing Address - Phone:510-583-5686
Mailing Address - Fax:
Practice Address - Street 1:20284 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4312
Practice Address - Country:US
Practice Address - Phone:510-583-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34763106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist