Provider Demographics
NPI:1407015902
Name:CHRISTIAN, CLIFFORD NELS (PHD)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:NELS
Last Name:CHRISTIAN
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 1:1046 W TAYLOR ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1815
Mailing Address - Country:US
Mailing Address - Phone:408-297-7348
Mailing Address - Fax:408-297-7354
Practice Address - Street 1:1046 W TAYLOR ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1815
Practice Address - Country:US
Practice Address - Phone:408-297-7348
Practice Address - Fax:408-297-7354
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor