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NPI Code Detail

MEDICARE: DR. CHRISTINE ELIZABETH FARIS

MEDICARE: DR. CHRISTINE ELIZABETH FARIS
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
1225C00000XRehabilitation Counselor
2103T00000XPsychologist
3101YS0200XSchool Counselor
4390200000XStudent in an Organized Health Care Education/Training Program
5101YM0800XMental Health Counselor
6103TC0700XClinical Psychologist36614CA

General Provider Information

NPI Number : 1811412141
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE ELIZABETH FARIS
Provider Business Mailing Address
First Line : 2650 E FOOTHILL BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91107-3439
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2650 E FOOTHILL BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91107-3439
Country : US
Telephone Number : 626-577-2261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 03/10/2026

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