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CHRISTINE MARTHA KOONTZ
NPI 1215550611
Social Worker - Clinical in Chino, CA

Active since May 20, 2020Opted out of Medicare · through Oct 18, 2027
4091 RIVERSIDE DR STE 214, CHINO, CA 91710(909) 255-0791 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Christine Martha Koontz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRISTINE MARTHA KOONTZ (NPI 1215550611) is an individual clinical provider in Chino, California, licensed in California (21942) and active in the NPI registry since May 2020. She has opted out of Medicare through October 18, 2027.

NPPES Registry Identity

NPI1215550611
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCHRISTINE MARTHA KOONTZ
Location Address4091 RIVERSIDE DR STE 214Chino, CA 91710-6502
Mailing Address4091 Riverside Dr Ste 214Chino, CA 91710-6502 · (909) 255-0791
Phone(909) 255-0791
Sole ProprietorNo
Enumeration DateMay 20, 2020
NPPES CertifiedMay 20, 2020
✔ NPI 1215550611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 21942
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4091 RIVERSIDE DR STE 214, Chino, CA 91710
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Christine Martha Koontz has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 18, 2023 through October 18, 2027.

Opt-Out Effective DateOctober 18, 2023
Opt-Out In Effect ThroughOctober 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LAURA MAURIE CRAVENS LCSW
Social Worker (Clinical)
4091 RIVERSIDE DR STE 214
CHINO, CA 91710
San Bernardino County (909) 833-0544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Christine Koontz's NPI number?

The NPI number for Christine Koontz is 1215550611. It was assigned to this individual provider in the NPPES registry on May 20, 2020.

Where is Christine Koontz located?

Christine Koontz practices at 4091 Riverside Dr Ste 214, Chino, CA 91710. The listed phone number is (909) 255-0791.

What is Christine Koontz's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Christine Koontz enrolled in Medicare?

No. Christine Koontz has opted out of Medicare through October 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Christine Koontz was last updated on May 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.