Provider Demographics
NPI:1437539392
Name:COON, CHRISTOPHER (CATC II)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:COON
Suffix:
Gender:M
Credentials:CATC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 W DUARTE RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6835
Mailing Address - Country:US
Mailing Address - Phone:626-232-4035
Mailing Address - Fax:626-447-1169
Practice Address - Street 1:453 W DUARTE RD
Practice Address - Street 2:UNIT 2
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-6835
Practice Address - Country:US
Practice Address - Phone:626-232-4035
Practice Address - Fax:626-447-1169
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142930II101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)