Provider Demographics
NPI:1396832663
Name:MASTERS, CHRISTINE M (MS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:MASTERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 BUNDREN ST
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-9460
Mailing Address - Country:US
Mailing Address - Phone:805-649-2566
Mailing Address - Fax:805-649-2566
Practice Address - Street 1:295 ARCADE STREET
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-389-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP2478235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist