MEDICARE: CHRISTINE HANNA MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	13252	CA
2	1041C0700X	Clinical Social Worker	LCSW82185	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101YM0800X	OTHER	CA	REGISTERED MSW

General Provider Information

NPI Number	:	1174665343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE HANNA MSW, LCSW

Provider Business Mailing Address
First Line	:	1060 EAST HILLS DR.
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791
Country	:	US
Telephone Number	:	626-915-2767
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 S TUSTIN ST BLDG B
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2550
Country	:	US
Telephone Number	:	714-244-4322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/27/2018

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