Provider Demographics
NPI:1558042242
Name:DREGNE, CHRISTOPHER JON (ACSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JON
Last Name:DREGNE
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 TELEPHONE RD # 300
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-8779
Mailing Address - Country:US
Mailing Address - Phone:805-236-5978
Mailing Address - Fax:
Practice Address - Street 1:4651 TELEPHONE RD # 300
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8779
Practice Address - Country:US
Practice Address - Phone:805-236-5978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW115033101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty