Provider Demographics
NPI:1407566789
Name:OLIVER, CHRISTOPHER EUGENE
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:EUGENE
Last Name:OLIVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3031
Mailing Address - Country:US
Mailing Address - Phone:323-249-9097
Mailing Address - Fax:323-249-9121
Practice Address - Street 1:9705 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3031
Practice Address - Country:US
Practice Address - Phone:323-249-9097
Practice Address - Fax:323-249-9121
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)