Provider Demographics
NPI:1285226746
Name:HAGAN, CHRISTOPHER RYAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:HAGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:IA
Mailing Address - Zip Code:52253-9788
Mailing Address - Country:US
Mailing Address - Phone:714-661-9673
Mailing Address - Fax:
Practice Address - Street 1:302 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:IA
Practice Address - Zip Code:52253-9788
Practice Address - Country:US
Practice Address - Phone:319-535-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty