Basic Information
| Provider Information | |||||||||
| NPI: | 1639587884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEORGE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.S.W., A.C.S.W. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 480 E. 13TH ST. | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953416214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093814800 | ||||||||
| FaxNumber: | 2097253761 | ||||||||
| Practice Location | |||||||||
| Address1: | 480 E 13TH ST | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953416214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093814800 | ||||||||
| FaxNumber: | 2097253761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2014 | ||||||||
| LastUpdateDate: | 07/31/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | ASW60651 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.