Individual
DR. CHRISTINE M VANDENBROUCKE-BOUCKAERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.IN CLINICAL PSY
Contact information
Practice address
1480 LINCOLN AVE, #12, SAN RAFAEL, CA 94901-2084
(415) 457-5145
(415) 382-9051
Mailing address
1480 LINCOLN AVE, #12, SAN RAFAEL, CA 94901-2084
(415) 457-5145
(415) 382-9051
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY18851
CA
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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