Individual provider Active NPI

Tim Rex Christner, RADT-1

  • Addiction (Substance Use Disorder) Counselor
  • Placerville, CA
National Provider Identifier
1063916849
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1260250817 Issued in CA
Practice address
2844 Coloma St
Placerville, CA 95667-4406
Phone
(530) 642-1715
Fax
(530) 642-2064
NPI assigned
Mar 19, 2018
Last updated
Mar 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1260250817 CA Primary

Addresses

Primary practice location

2844 Coloma St
Placerville, CA 95667-4406

Mailing address

PO Box 1666
Placerville, CA 95667-1666
Phone (530) 642-1715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1260250817CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1063916849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1666",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956671666",
            "telephone_number": "530-642-1715",
            "fax_number": "530-642-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 COLOMA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674406",
            "telephone_number": "530-642-1715",
            "fax_number": "530-642-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTNER",
        "first_name": "TIM",
        "middle_name": "REX",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1260250817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.