Provider Demographics
NPI:1205133808
Name:HARRIOTT, CHRISTOPHER T (LMFT, MA, MS, PPS)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:T
Last Name:HARRIOTT
Suffix:
Gender:M
Credentials:LMFT, MA, MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10526 DUBNOFF WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91343
Mailing Address - Country:US
Mailing Address - Phone:818-892-3423
Mailing Address - Fax:818-893-4509
Practice Address - Street 1:10526 DUBNOFF WAY
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3921
Practice Address - Country:US
Practice Address - Phone:818-775-4950
Practice Address - Fax:818-752-0783
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53530106H00000X
CA63660106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDI-CAL
CA95-2633765OtherMEDICAL