Provider Demographics
NPI:1205980364
Name:JANSEN-YEE, CHRISTIAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:JANSEN-YEE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 GLADE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-2778
Mailing Address - Country:US
Mailing Address - Phone:231-737-1213
Mailing Address - Fax:231-737-1218
Practice Address - Street 1:3370 GLADE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-2778
Practice Address - Country:US
Practice Address - Phone:231-737-1213
Practice Address - Fax:231-737-1218
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383175556OtherASR
MI507110OtherPREFERRED CHOICES
MI244735000OtherMAGELLAN
MI383175556OtherPPOM
MI680F145160OtherBCBS MI
MI7000010001OtherPRIORITY HEALTH
MIOF14516OtherVALUE OPTIONS
MIP86569OtherBCN
MIOF14516OtherVALUE OPTIONS