Provider Demographics
NPI:1710019922
Name:GILES, CHRISTINA LOUISE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:GILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11048 ENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4409
Mailing Address - Country:US
Mailing Address - Phone:818-523-1416
Mailing Address - Fax:818-363-1369
Practice Address - Street 1:11565 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4168
Practice Address - Country:US
Practice Address - Phone:818-838-1352
Practice Address - Fax:818-838-1362
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30828106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist