Provider Demographics
NPI:1164204863
Name:BROWN, CHRISTINE LEIGH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7677 ALDERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9745
Mailing Address - Country:US
Mailing Address - Phone:951-403-5681
Mailing Address - Fax:
Practice Address - Street 1:7677 ALDERWOOD AVE
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-9745
Practice Address - Country:US
Practice Address - Phone:951-403-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA696211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical