Individual provider · Type 1 NPI
Kristina Lynn Gillam
Peer Specialist · Joshua Tree, CA
NPI number
1194231118
Active
Practice location
61607 29 Palms Hwy Ste D
Joshua Tree, CA 92252-2391
Fax (760) 366-3365
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1265160917 (CA) |
| Peer Specialist Primary | 175T00000X | None listed |
Peer Specialist: 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.
About NPI 1194231118
Kristina Lynn Gillam's National Provider Identifier is 1194231118, issued on Dec 28, 2017. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Joshua Tree, CA. The record was last updated on Sep 30, 2021.