Provider Demographics
NPI:1093208373
Name:HAGION-RZEPKA, CHRISTINE E (MPH, PHD PRACTICUM)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:HAGION-RZEPKA
Suffix:
Gender:F
Credentials:MPH, PHD PRACTICUM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36106
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95158-6106
Mailing Address - Country:US
Mailing Address - Phone:408-674-3084
Mailing Address - Fax:
Practice Address - Street 1:1080 N. 7TH STREET
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-9998
Practice Address - Country:US
Practice Address - Phone:408-998-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health