Doctor Name: | DR. CHRISTINE BIERDRAGER-SALLEY |
NPI Number: | 1003091562 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | PSY17704 |
Business Practice Address: | 1963 N E St San Bernardino, CA - 924053919 |
Business Phone Number: | 9098836146 |
Business Fax Number: | 9098830111 |
Mailing Address: | 1963 N E St, SAN BERNARDINO |
State: | CA |
Postal Code: | 924053919 |
Phone Number: | 9098836146 |
Fax Number: | 9098830111 |
NPI Enumeration Date: | 01/03/2008 |
NPI Last Update Date: | 12/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY17704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |