Provider Demographics
NPI:1992102255
Name:POPE, CHRYSTINA ANN (PHD,ABD, LMFT)
Entity type:Individual
Prefix:
First Name:CHRYSTINA
Middle Name:ANN
Last Name:POPE
Suffix:
Gender:F
Credentials:PHD,ABD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 BEL AIRE WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-1103
Mailing Address - Country:US
Mailing Address - Phone:805-400-0248
Mailing Address - Fax:
Practice Address - Street 1:162J GROVE ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2640
Practice Address - Country:US
Practice Address - Phone:760-873-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA82943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No251S00000XAgenciesCommunity/Behavioral Health