| Mary Christie | |
|
665 Camino De Los Mares Ste 203a San Clemente CA 92673-2836 | |
| (949) 363-3456 | |
| (949) 493-4622 |
| Full Name | Mary Christie |
|---|---|
| Speciality | Counselor |
| Location | 665 Camino De Los Mares Ste 203a, San Clemente, California |
| Authorized Official Name and Position | Mary Christie (PRESIDENT) |
| Authorized Official Contact | 9493633456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Christie 25544 Paseo La Vis Laguna Niguel CA 92677-4401 Ph: (949) 363-3456 | Mary Christie 665 Camino De Los Mares Ste 203a San Clemente CA 92673-2836 Ph: (949) 363-3456 |
| NPI Number | 1891596797 |
|---|---|
| Provider Enumeration Date | 03/24/2025 |
| Last Update Date | 07/02/2025 |
| Certification Date | 07/02/2025 |
| Medicare PECOS PAC ID | 8527579929 |
|---|---|
| Medicare Enrollment ID | O20250613000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891596797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Mary Christie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568601367 PECOS PAC ID: 5395256796 Enrollment ID: I20250723002787 |
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