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Organization
KATHERINE CLAIR TRISTAN LCSW PC
Active
Organization
KATHERINE CLAIR TRISTAN LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE TRISTAN LCSW (CLINICAL THERAPIST)
(951) 823-3498
Entity
Organization
Contact information
Practice address
255 N D ST STE 220, SAN BERNARDINO, CA 92401-1713
(951) 823-3498
Mailing address
255 N D ST STE 220, SAN BERNARDINO, CA 92401-1713
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336575380
IEHP
CA
Enumeration date
12/04/2018
Last updated
12/04/2018
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