Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY17856 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY17856 | CA |
Y | 103G00000X | Clinical Psychologist | PSY17856 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY17856 | CA |
NPI | 1437361912 |
---|---|
Provider Name | Dr. Christina Lynn Gietzen-Haraden |
First Address | San Diego, CA 92111-2261 |
Second Address | San Diego, CA 92111-2261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 26/04/2011 |