Provider Demographics
NPI:1891113767
Name:JUAREZ, CHRISTOPHER BENIGNO (ACSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BENIGNO
Last Name:JUAREZ
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 N CHINOWTH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7896
Mailing Address - Country:US
Mailing Address - Phone:559-635-4780
Mailing Address - Fax:559-635-4790
Practice Address - Street 1:3424 W PACKWOOD AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5000
Practice Address - Country:US
Practice Address - Phone:559-635-4780
Practice Address - Fax:559-635-4790
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 171M00000X
CAASW92312104100000X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator