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General NPI Number Information
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NPI Number | 1093208373
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Entity Type | Individual
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Provider Name | CHRISTINE E HAGION-RZEPKA MPH, PHD PRACTICUM
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 1080 N. 7TH STREET
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City | SAN JOSE
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State | CA
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Zip | 95112-9998
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Country | US
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Telephone | 408-998-1774
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36106
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City | SAN JOSE
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State | CA
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Zip | 95158-6106
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Country | US
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Telephone | 408-674-3084
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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