Provider Demographics
NPI:1235489402
Name:RABA, CHRISTINE LAVONNE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LAVONNE
Last Name:RABA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 HILLSBORO PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3344
Mailing Address - Country:US
Mailing Address - Phone:615-208-6440
Mailing Address - Fax:615-866-4717
Practice Address - Street 1:160 E. VIRGINIA ST.
Practice Address - Street 2:SUITE 280
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5817
Practice Address - Country:US
Practice Address - Phone:408-287-6200
Practice Address - Fax:408-998-1535
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP0000003358OtherLICENSE