Provider Demographics
NPI:1255196309
Name:HIXSON, CHRISTOPHER ADAM (LVN, EMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ADAM
Last Name:HIXSON
Suffix:
Gender:M
Credentials:LVN, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32993 LAKE BLUESTONE ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1212
Mailing Address - Country:US
Mailing Address - Phone:202-689-4465
Mailing Address - Fax:
Practice Address - Street 1:32993 LAKE BLUESTONE ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-1212
Practice Address - Country:US
Practice Address - Phone:202-689-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE159539146N00000X
CA744950164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic