MEDICARE: CHRISTOPHER LAWRENCE LYNCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1033851639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER LAWRENCE LYNCH

Provider Business Mailing Address
First Line	:	1914 22ND ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-7109
Country	:	US
Telephone Number	:	916-455-6258
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 LAURINE WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95824-2961
Country	:	US
Telephone Number	:	916-306-3023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	04/13/2022

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