Provider Demographics
NPI:1952321697
Name:MCMAHON, CHRISTINE M (PSYD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 BEAUMONT AVE
Mailing Address - Street 2:#224
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-5900
Mailing Address - Country:US
Mailing Address - Phone:951-845-9860
Mailing Address - Fax:951-845-9148
Practice Address - Street 1:790 BEAUMONT AVE
Practice Address - Street 2:#224
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-5900
Practice Address - Country:US
Practice Address - Phone:951-845-9860
Practice Address - Fax:951-845-9148
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14352103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical