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NPI 1053814764

NPI 1053814764 : JENNIFER RENEE CHRISTOPHER : BELLFLOWER, CA

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General NPI Number Information
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    NPI Number           |    1053814764
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER RENEE CHRISTOPHER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/09/2018
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    Last Update Date     |    03/09/2018
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Provider Practice Location Address
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    Address Line         |    9718 HARVARD ST 
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    City                 |    BELLFLOWER
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    State                |    CA
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    Zip                  |    90706-3635
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    Country              |    US
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    Telephone            |    562-925-2777
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    Fax                  |    562-925-7572
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Provider Business Mailing Address
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    Address Line         |    9718 HARVARD ST 
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    City                 |    BELLFLOWER
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    State                |    CA
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    Zip                  |    90706-3635
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    Country              |    US
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    Telephone            |    562-925-2777
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    R1285441217
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    License Number State |    CA
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