Healthcare Provider Details

I. General information

NPI: 1639928724
Provider Name (Legal Business Name): CHRISTINE HEJINIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 23RD ST
SAN FRANCISCO CA
94114-3111
US

IV. Provider business mailing address

4321 23RD ST
SAN FRANCISCO CA
94114-3111
US

V. Phone/Fax

Practice location:
  • Phone: 415-346-9383
  • Fax:
Mailing address:
  • Phone: 415-346-9383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY8227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: