Provider Demographics
NPI:1750932182
Name:KHOUIE, CHRISTINA (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KHOUIE
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14742 NEWPORT AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6177
Mailing Address - Country:US
Mailing Address - Phone:800-556-4602
Mailing Address - Fax:
Practice Address - Street 1:14742 NEWPORT AVE STE 208
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6177
Practice Address - Country:US
Practice Address - Phone:833-903-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88221106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist