Individual provider Active NPI

Kristie Christensen, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1629499348
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 24522 Issued in CA
Practice address
1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800
Phone
(559) 304-9804
NPI assigned
Dec 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 24522 CA Primary

Addresses

Primary practice location

1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800

Mailing address

1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800
Phone (559) 304-9804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 28, 2020 through Dec 28, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 24522CAMDClinical Social Worker
24522CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1629499348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 E BULLARD AVE STE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105800",
            "telephone_number": "559-304-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 E BULLARD AVE STE 100",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105800",
            "telephone_number": "559-304-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "KRISTIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW  24522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.