Individual
CHRISTINE K TA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1301 PINE AVE, LONG BEACH, CA 90813
(562) 595-1159
Mailing address
1301 PINE AVE, LONG BEACH, CA 90813-3124
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY33562
CA
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
09/21/2016
Last updated
09/08/2022
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