Provider Demographics
NPI:1245564335
Name:LANNERS, CHRISTINA GAIL (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:GAIL
Last Name:LANNERS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CHRISITNA
Other - Middle Name:GAIL
Other - Last Name:HESSELTINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:100 CALAIS ST
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-5422
Mailing Address - Country:US
Mailing Address - Phone:949-690-1617
Mailing Address - Fax:
Practice Address - Street 1:100 CALAIS ST
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-5422
Practice Address - Country:US
Practice Address - Phone:949-690-1617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist