Christine P McKillop

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6302 Thirteenth Avenue
Lucerne, CA 95458

Phone

(707) 274-9101

Fax

(707) 274-9192

NPI assigned

Feb 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1407555428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7393 ANCHOR DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229085",
            "telephone_number": "916-517-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 THIRTEENTH AVENUE",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "95458",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7393 Anchor Dr",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954229085",
            "country_code": "US",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7000B S Center Dr",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954228131",
            "country_code": "US",
            "telephone_number": "707-994-7090",
            "fax_number": "707-994-7164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKILLOP",
        "first_name": "CHRISTINE",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucerne Fire Department
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• Karen Macall
• Priest Martinez
• Dennis Mason
• Anthony Gale Miszklevitz, D.C.
• Steve Mueller
• Rosemary Narvaes
• Teresa Eileen Newton
• North Shore Fire Protection District

• Addiction (Substance Use Disorder) Counselor in Lucerne, CA
• Providers in Lucerne, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.