Provider Demographics
NPI:1215638606
Name:KHAN, CHRISTOPHER H (RAS II)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:H
Last Name:KHAN
Suffix:
Gender:M
Credentials:RAS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 SUSAN WAY
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9266
Mailing Address - Country:US
Mailing Address - Phone:209-588-6164
Mailing Address - Fax:
Practice Address - Street 1:19401 SUSAN WAY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9266
Practice Address - Country:US
Practice Address - Phone:209-588-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAK2012101052101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)