| Doctor Name: | DR. CHRISTINE MARIE FAHRENBACH |
| NPI Number: | 1013021104 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY 14736 |
| Business Practice Address: | 725 Front St Ste 200 Santa Cruz, CA - 950604538 |
| Business Phone Number: | 8314576601 |
| Business Fax Number: | 8314597504 |
| Mailing Address: | 725 Front St Ste 200, SANTA CRUZ |
| State: | CA |
| Postal Code: | 950604538 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 09/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 14736 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |