Provider Demographics
NPI:1558317289
Name:CHRISTENSEN, ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28631 S WESTERN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-0816
Mailing Address - Country:US
Mailing Address - Phone:310-463-4538
Mailing Address - Fax:
Practice Address - Street 1:28631 S WESTERN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0816
Practice Address - Country:US
Practice Address - Phone:310-463-4538
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS160541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW16054Medicare ID - Type Unspecified