MEDICARE: CHRISTOPHER JAMES DRENNEN MS,IMFT

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	106H00000X	Marriage & Family Therapist	IMF51939	CA

General Provider Information

NPI Number	:	1447374889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES DRENNEN MS,IMFT

Provider Business Mailing Address
First Line	:	8130 NORTON AVE
Second Line	:	#17
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-4957
Country	:	US
Telephone Number	:	323-650-3120
Fax Number	:

Provider Business Practice Location Address
First Line	:	4618 FOUNTAIN AVE
Second Line	:	#102
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1830
Country	:	US
Telephone Number	:	323-644-6180
Fax Number	:	323-663-2448

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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