Provider Demographics
NPI:1750783510
Name:ZWICKY, CHRISTINE (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ZWICKY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 ALA MOANA BLVD APT D106
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1331
Mailing Address - Country:US
Mailing Address - Phone:602-692-5503
Mailing Address - Fax:
Practice Address - Street 1:1400 PARKMOOR AVE STE 115
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3797
Practice Address - Country:US
Practice Address - Phone:408-510-3480
Practice Address - Fax:408-510-3484
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health