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General NPI Number Information
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NPI Number | 1588170179
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Entity Type | Individual
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Provider Name | CHRISTINA CAUBLE
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 15519 CRENSHAW BLVD
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City | GARDENA
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State | CA
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Zip | 90249-4525
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Country | US
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Telephone | 310-679-9126
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Fax |
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Provider Business Mailing Address
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Address Line | 3143 W 180TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-4013
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Country | US
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Telephone | 310-634-3788
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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 | APCC10982
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 8147
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License Number State | CA
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