Provider Demographics
NPI:1427698000
Name:HENSLEY, CHRISTOPHER (LMT, CMT, BCMTB)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:LMT, CMT, BCMTB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 DEER MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:OCCIDENTAL
Mailing Address - State:CA
Mailing Address - Zip Code:95465-9222
Mailing Address - Country:US
Mailing Address - Phone:707-567-7178
Mailing Address - Fax:
Practice Address - Street 1:3680 DEER MEADOW LN
Practice Address - Street 2:
Practice Address - City:OCCIDENTAL
Practice Address - State:CA
Practice Address - Zip Code:95465-9222
Practice Address - Country:US
Practice Address - Phone:707-567-7178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60968576225700000X
CA67254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA67254OtherCALIFORNIA MASSAGE THERAPY COUNCIL
860926OtherNATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK