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NPI Code Detail

MEDICARE: CHRISTINE ALICIA MCREYNOLDS LCSW

MEDICARE: CHRISTINE ALICIA MCREYNOLDS LCSW
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
11041C0700XClinical Social Worker68058CA

General Provider Information

NPI Number : 1093448060
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ALICIA MCREYNOLDS LCSW
Provider Business Mailing Address
First Line : 1515 E OCEAN AVE
Second Line :
City : LOMPOC
State : CA
Zip : 93436-7092
Country : US
Telephone Number : 805-737-5791
Fax Number : 805-875-8901
Provider Business Practice Location Address
First Line : 1301 N A ST
Second Line :
City : LOMPOC
State : CA
Zip : 93436-3516
Country : US
Telephone Number : 805-742-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2022
Last Update Date : 01/19/2026

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Directions to “ CHRISTINE ALICIA MCREYNOLDS LCSW” Practice Location

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