Christopher Allen Canclini, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

53907 Issued in CA

Practice address

330 James Way Ste 180
Pismo Beach, CA 93449-2891

Phone

(805) 598-0631

NPI assigned

May 20, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beth David Counseling Services

  • Marriage & Family Therapist
  • Pismo Beach, CA
  • NPI 1114373123
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1629397229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 JAMES WAY STE 180",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492891",
            "telephone_number": "805-598-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 JAMES WAY STE 180",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492891",
            "telephone_number": "805-598-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCLINI",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ludmila Burcovschi, NP
• Miriam Burlakovsky, ED.S, BCBA, LEP#4368
• Julie Lynne Butler, PT
• Byron Collier DPM Inc
• Nichole Christine Calderon, RBT
• David Alan Canvasser, M.D.
• Jessica Cardenas Cordova, BA
• Lily Carr, LCSW
• Central Coast Cardiothoracic Surgical Associates-a Medical Group
• Central Coast Orthopedic Medical Group

• Marriage & Family Therapist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.