Provider Demographics
NPI:1659675833
Name:LIVINGSTON, CHRISTOPHER (CAADE)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:CAADE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 RINCONADA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-3033
Mailing Address - Country:US
Mailing Address - Phone:707-539-6923
Mailing Address - Fax:
Practice Address - Street 1:3315 AIRWAY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2005
Practice Address - Country:US
Practice Address - Phone:707-523-2242
Practice Address - Fax:707-526-3817
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator