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General NPI Number Information
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NPI Number | 1568130557
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Entity Type | Individual
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Provider Name | CHRISTINA DILLARD EDD, LEP3529
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 1609 BEECH AVE
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City | TORRANCE
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State | CA
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Zip | 90501-3117
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Country | US
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Telephone | 213-247-7005
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 BEECH AVE
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City | TORRANCE
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State | CA
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Zip | 90501-3117
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Country | US
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Telephone | 213-247-7005
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | LEP3529
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License Number State |
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