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General NPI Number Information
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NPI Number | 1467915876
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Entity Type | Individual
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Provider Name | MARIA CHRISTINA TREVINO-JUNGERS LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 600 BROADWAY ST
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City | LONGVIEW
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State | WA
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Zip | 98632-3256
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Country | US
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Telephone | 360-414-2236
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Fax | 360-414-2024
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Provider Business Mailing Address
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Address Line | 30 CLOVER ST
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City | CATHLAMET
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State | WA
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Zip | 98612-9511
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Country | US
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Telephone | 360-795-3299
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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 | 61029563
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SC60499434
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License Number State | WA
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