Provider Demographics
NPI:1235258922
Name:CHRISTRUP, JAMES J (MSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:CHRISTRUP
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 LONGCROFT DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2523
Mailing Address - Country:US
Mailing Address - Phone:415-242-9866
Mailing Address - Fax:
Practice Address - Street 1:4326 18TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2427
Practice Address - Country:US
Practice Address - Phone:415-242-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 151511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical