Provider Demographics
NPI:1194573618
Name:BREEN, CHRISTIAN O'RYAN
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:O'RYAN
Last Name:BREEN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:O'RYAN
Other - Last Name:BREEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:251 OAK VIEW CT
Mailing Address - Street 2:
Mailing Address - City:SUTTER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95685-4302
Mailing Address - Country:US
Mailing Address - Phone:209-790-9194
Mailing Address - Fax:
Practice Address - Street 1:251 OAK VIEW CT
Practice Address - Street 2:
Practice Address - City:SUTTER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95685-4302
Practice Address - Country:US
Practice Address - Phone:209-790-9194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician