Healthcare Provider Details
I. General information
NPI: 1275787301
Provider Name (Legal Business Name): MS. CHRISTINE DEBORAH PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/17/2008
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23824 HAWTHORNE BLVD STE 200
TORRANCE CA
90505-5935
US
IV. Provider business mailing address
9542 BASCOM ST
PICO RIVERA CA
90660-4271
US
V. Phone/Fax
- Phone: 310-791-3064
- Fax: 310-791-3084
- Phone: 626-347-2555
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225400000X |
| Taxonomy | Rehabilitation Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: