Provider Demographics
NPI:1174947766
Name:THOMSEN, CHRISTINA NICOLE (HHP, LMT,)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:NICOLE
Last Name:THOMSEN
Suffix:
Gender:F
Credentials:HHP, LMT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2496 E ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-6208
Mailing Address - Country:US
Mailing Address - Phone:360-220-7155
Mailing Address - Fax:
Practice Address - Street 1:2496 E ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-6208
Practice Address - Country:US
Practice Address - Phone:360-220-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6862225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist