Provider Demographics
NPI:1992022842
Name:NUNEZ, S CHRISTOPHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:S CHRISTOPHER
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 WESTWOOD BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2925
Mailing Address - Country:US
Mailing Address - Phone:213-709-4453
Mailing Address - Fax:
Practice Address - Street 1:1081 WESTWOOD BLVD STE 212
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2925
Practice Address - Country:US
Practice Address - Phone:213-709-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X, 103T00000X
CAPSY23631103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY236310Medicaid
CAPSY236310Medicaid