Provider Demographics
NPI:1992420665
Name:STINSON, CHRISTY (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19198 RICARDO RANCH RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6825
Mailing Address - Country:US
Mailing Address - Phone:949-636-1020
Mailing Address - Fax:
Practice Address - Street 1:4025 CAMINO DEL RIO S STE 250
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4100
Practice Address - Country:US
Practice Address - Phone:619-858-3105
Practice Address - Fax:619-280-5420
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26276104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker