Healthcare Provider Details

I. General information

NPI: 1760113120
Provider Name (Legal Business Name): CHRISTOPHER CAPRON PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SERENITY LN
COBURG OR
97408-9350
US

IV. Provider business mailing address

PO BOX 8549
COBURG OR
97408-1313
US

V. Phone/Fax

Practice location:
  • Phone: 541-262-0788
  • Fax:
Mailing address:
  • Phone: 541-284-5690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: