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Kristina Lynn Gillam
Peer Specialist in Joshua Tree, California
NPI 1194231118

Kristina Lynn Gillam is a Peer Specialist based in Joshua Tree, CA. Kristina Lynn Gillam practices in Joshua Tree, CA. The NPI Number for Kristina Lynn Gillam is 1194231118 and holds a License No. R1265160917 (California).

The current practice location address for Kristina Lynn Gillam is 61607 29 Palms Hwy Ste D, Joshua Tree, CA and can be reached out via phone at 760-366-8641 and via fax at 760-366-3365.

Location: 61607 29 Palms Hwy Ste D, Joshua Tree, CA, 92252-2391
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194231118
Provider Name
Kristina Lynn Gillam
Credential
Provider Entity Type
Individual
Gender
Female
Address
61607 29 Palms Hwy Ste D, Joshua Tree, CA, 92252-2391
Phone Number
760-366-8641
Fax Number
760-366-3365
Provider Enumeration Date
12/28/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
61607 29 Palms Hwy Ste D
City
Joshua Tree
State
California
Zip
92252-2391
Phone Number
760-366-8641
Fax Number
760-366-3365
person
Provider Business Mailing Address Details
Address
61607 29 Palms Hwy Ste D
City
Joshua Tree
State
California
Zip
92252-2391
Phone Number
760-366-8641
Fax Number
760-366-3365
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
R1265160917 (California)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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