Wise, Christy
Wise, Christy is an individual health care provider with primary practice located at 1104 Camino Del Mar Suite 107, Del Mar CA 92014-2656. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wise, Christy can be contacted via phone (877) 880-7337.Contact Information
Primary practice address
1104 Camino Del Mar Suite 107
Del Mar CA 92014-2656
Phone: (877) 880-7337
Fax: (858) 923-1121
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY19841 | California |
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | PSY19841 | California |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PSY19841 | California |
Profile Details
NPI number | 1407839012 |
---|---|
LBN Legal business name | Wise, Christy |
Credentials | PSY.D. |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 29th, 2005 |
Last updated | Jan 17th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407839012 | NPPES |
California | Other | 11521017 | CAQH |
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