Provider Demographics
NPI:1043312689
Name:ADAMS, CHRISTINE C (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:A
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:25283 CABOT ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-244-7250
Mailing Address - Fax:
Practice Address - Street 1:25283 CABOT ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-244-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS171021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical