Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS 26134 | CA |
NPI | 1003168865 |
---|---|
Provider Name | Christina Janet Stimmann |
First Address | Fairfield, CA 94533-6717 |
Second Address | Fairfield, CA 94533-6372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2012 |
Last Update Date | 01/12/2020 |