Provider Demographics
NPI:1285074864
Name:RASMUSSEN, CHRISTINE MARIA (MT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIA
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 E THOUSAND OAKS BLVD # 207
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3434
Mailing Address - Country:US
Mailing Address - Phone:805-907-0642
Mailing Address - Fax:
Practice Address - Street 1:3275 EAST THOUSAND OAKS BOULEVARD
Practice Address - Street 2:SUITE NUMBER 207
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362
Practice Address - Country:US
Practice Address - Phone:805-907-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZ87981174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist