Basic Information
| Provider Information | |||||||||
| NPI: | 1851433486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OFFOR | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25244 CORAL CANYON RD | ||||||||
| Address2: | |||||||||
| City: | CORONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093689336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 831 EAST ARROW HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093984383 | ||||||||
| FaxNumber: | 9094458936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 02/21/2017 | ||||||||
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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 | 106H00000X | 96115 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.