Provider Demographics
NPI:1568627461
Name:CRAIG, CHRISTOPHER GEOFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GEOFFREY
Last Name:CRAIG
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 1:7800 TOPANGA CANYON BLVD
Mailing Address - Street 2:APT. 318
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5553
Mailing Address - Country:US
Mailing Address - Phone:818-710-1290
Mailing Address - Fax:818-710-1290
Practice Address - Street 1:7800 TOPANGA CANYON BLVD
Practice Address - Street 2:APT. 318
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-5553
Practice Address - Country:US
Practice Address - Phone:818-710-1290
Practice Address - Fax:818-710-1290
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17645103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist