Provider Demographics
NPI:1679600506
Name:LUKOFF, CHRISTEL F (PHD MFT)
Entity type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:F
Last Name:LUKOFF
Suffix:
Gender:F
Credentials:PHD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 B ST
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-4026
Mailing Address - Country:US
Mailing Address - Phone:707-763-3504
Mailing Address - Fax:
Practice Address - Street 1:1035 B ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-4026
Practice Address - Country:US
Practice Address - Phone:707-763-3504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMS020024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health