Provider Demographics
NPI:1134106362
Name:HSU, CHRISTENSEN SICAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTENSEN
Middle Name:SICAT
Last Name:HSU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTENSEN
Other - Middle Name:COSME
Other - Last Name:SICAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5256 S MISSION RD STE 1103
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-3624
Mailing Address - Country:US
Mailing Address - Phone:760-350-2060
Mailing Address - Fax:760-350-2064
Practice Address - Street 1:5256 S MISSION RD STE 1103
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-3624
Practice Address - Country:US
Practice Address - Phone:760-350-2060
Practice Address - Fax:760-350-2064
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16248122300000X
CA44362122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist