Provider Demographics
NPI:1174342414
Name:REZA, CHRISTOPHER STEVE
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:STEVE
Last Name:REZA
Suffix:
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 1:858 FILBERT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-2641
Mailing Address - Country:US
Mailing Address - Phone:510-364-4786
Mailing Address - Fax:
Practice Address - Street 1:858 FILBERT ST APT 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-2641
Practice Address - Country:US
Practice Address - Phone:510-364-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst