Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY17704 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY17704 | CA |
NPI | 1003091562 |
---|---|
Provider Name | Dr. Christine Bierdrager-Salley |
First Address | San Bernardino, CA 92405-3919 |
Second Address | San Bernardino, CA 92401-1109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2008 |
Last Update Date | 05/02/2021 |