Healthcare Provider Details
I. General information
NPI: 1255246393
Provider Name (Legal Business Name): CHRISTIAN BANKS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1385 N PURDUE AVE
CLOVIS CA
93619-9807
US
IV. Provider business mailing address
1385 N PURDUE AVE
CLOVIS CA
93619-9807
US
V. Phone/Fax
- Phone: 747-303-8686
- Fax:
- Phone: 747-303-8686
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: