Provider Demographics
NPI:1942719869
Name:CHRISTENSEN, RUTH LISA (LCSW 100267)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:LISA
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LCSW 100267
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:LISA
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 QUEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-9715
Mailing Address - Country:US
Mailing Address - Phone:559-992-7100
Mailing Address - Fax:
Practice Address - Street 1:4151 MEXICALI DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2065
Practice Address - Country:US
Practice Address - Phone:866-707-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1002671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical