Provider Demographics
NPI:1033633847
Name:MOLINO, CHRISTY C
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:C
Last Name:MOLINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N HIGHLAND AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1847
Mailing Address - Country:US
Mailing Address - Phone:310-722-3512
Mailing Address - Fax:
Practice Address - Street 1:225 N HIGHLAND AVE APT 201
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1847
Practice Address - Country:US
Practice Address - Phone:310-722-3512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical