Provider Demographics
NPI:1609192145
Name:ATTIKEN, CHRISTINA (MPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ATTIKEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 DOVER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5962
Mailing Address - Country:US
Mailing Address - Phone:424-644-9202
Mailing Address - Fax:
Practice Address - Street 1:881 DOVER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5962
Practice Address - Country:US
Practice Address - Phone:424-644-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT24596AMedicare PIN