Provider Demographics
NPI:1922295716
Name:SMITH, CHRISTINE E (CSAC1)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:CSAC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 W OLDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6518
Mailing Address - Country:US
Mailing Address - Phone:661-349-3203
Mailing Address - Fax:
Practice Address - Street 1:1609 E PALMDALE BLVD STE G
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4881
Practice Address - Country:US
Practice Address - Phone:661-947-1595
Practice Address - Fax:661-272-0415
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator