Individual
DIANE CHRISTOPHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1502 N. COAST HIGHWAY, LAGUNA BEACH, CA 92651-3103
(949) 497-3212
(949) 497-1564
Mailing address
1278 GLENNEYRE ST STE 233, LAGUNA BEACH, CA 92651-3103
(949) 497-3212
(949) 497-1564
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
18358
CA
111NX0800X
Orthopedic Chiropractor
DC18358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0183580
BLUE SHIELD
CA
Enumeration date
07/05/2006
Last updated
06/09/2015
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