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General NPI Number Information
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NPI Number | 1023826377
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Entity Type | Individual
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Provider Name | CHRISTA JINN CUISON
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 15720 VENTURA BLVD STE 420
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City | ENCINO
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State | CA
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Zip | 91436-4711
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Country | US
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Telephone | 818-927-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 2783 SAVANNAH CT
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City | CHULA VISTA
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State | CA
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Zip | 91914-4219
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Country | US
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Telephone | 619-974-4780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 98280
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License Number State | CA
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