Provider Demographics
NPI:1669503710
Name:PERIMAN, CHRISTINE MICHELLE (LAADC- CA, CATC IV)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:PERIMAN
Suffix:
Gender:F
Credentials:LAADC- CA, CATC IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2442
Mailing Address - Country:US
Mailing Address - Phone:562-388-4953
Mailing Address - Fax:
Practice Address - Street 1:21505 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-1121
Practice Address - Country:US
Practice Address - Phone:562-916-7581
Practice Address - Fax:562-916-7592
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANCACI 014790101YA0400X
CAMRAS-P0703071725101YA0400X
CACATCIV-1711379IV101YA0400X
CALAADC-CA-LCI10510218101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)