Provider Demographics
NPI:1932443728
Name:HINES, CHRISTINE FREDERICI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:FREDERICI
Last Name:HINES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W. ARBOR DR.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8745
Mailing Address - Country:US
Mailing Address - Phone:161-957-4861
Mailing Address - Fax:619-296-1852
Practice Address - Street 1:200 W. ARBOR DR.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8745
Practice Address - Country:US
Practice Address - Phone:161-957-4861
Practice Address - Fax:619-296-1852
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 155041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical