Provider Demographics
NPI:1588955207
Name:TRONGE, CHRISTINE (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TRONGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAPLE ST
Mailing Address - Street 2:#2203
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1963
Mailing Address - Country:US
Mailing Address - Phone:408-677-0174
Mailing Address - Fax:
Practice Address - Street 1:2680 S WHITE RD
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2074
Practice Address - Country:US
Practice Address - Phone:408-755-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical