Healthcare Provider Details

I. General information

NPI: 1184922106
Provider Name (Legal Business Name): CHRISTY TRASK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 S MOONEY BLVD UNIT B
VISALIA CA
93277-9535
US

IV. Provider business mailing address

6500 S MOONEY BLVD UNIT B
VISALIA CA
93277-9535
US

V. Phone/Fax

Practice location:
  • Phone: 559-685-1200
  • Fax: 559-685-9742
Mailing address:
  • Phone: 559-685-1200
  • Fax: 559-685-9742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: