Healthcare Provider Details
I. General information
NPI: 1518898311
Provider Name (Legal Business Name): CHRISTINE JOY PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1052 HEBER AVE
HEBER CA
92249-9759
US
IV. Provider business mailing address
1910 AURORA DR
EL CENTRO CA
92243-4108
US
V. Phone/Fax
- Phone: 760-337-6530
- Fax: 760-352-3534
- Phone: 760-337-6530
- Fax: 760-352-3534
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | 8640 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: