Provider Demographics
NPI:1184790693
Name:HARRIS, CHRISTA L (PT)
Entity type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:L
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:24955 PACIFIC COAST HWY
Mailing Address - Street 2:C-102
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4700
Mailing Address - Country:US
Mailing Address - Phone:310-456-9332
Mailing Address - Fax:310-456-5868
Practice Address - Street 1:24955 PACIFIC COAST HWY
Practice Address - Street 2:C-102
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4700
Practice Address - Country:US
Practice Address - Phone:310-456-9332
Practice Address - Fax:310-456-5868
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT145252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic