Provider Demographics
NPI:1790997559
Name:LAWSON, CHRISTINE LYNN (PHD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNN
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25550 HAWTHORNE BLVD
Mailing Address - Street 2:#316
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-373-5100
Mailing Address - Fax:310-375-8187
Practice Address - Street 1:25550 HAWTHORNE BLVD
Practice Address - Street 2:#316
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-373-5100
Practice Address - Fax:310-375-8187
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17633103TC0700X
IDPSY202271103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDPSY202271OtherBUREAU OF OCCUPTL LICENSE