Provider Demographics
NPI:1801810205
Name:ROSIK, CHRISTOPHER HASTINGS (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HASTINGS
Last Name:ROSIK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 W MENLO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1492
Mailing Address - Country:US
Mailing Address - Phone:559-439-4914
Mailing Address - Fax:559-439-4914
Practice Address - Street 1:1734 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3416
Practice Address - Country:US
Practice Address - Phone:559-439-2647
Practice Address - Fax:559-439-4712
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10532103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL10532Medicare UPIN