Provider Demographics
NPI:1114591088
Name:BROWN, CHRISTOPHER JR
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-1812
Mailing Address - Country:US
Mailing Address - Phone:909-566-5446
Mailing Address - Fax:
Practice Address - Street 1:1154 E 36TH ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-1812
Practice Address - Country:US
Practice Address - Phone:909-918-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-16
Last Update Date:2021-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst