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NPI Code Detail

MEDICARE: KRESTA LEE DALRYMPLE AMFT

MEDICARE: KRESTA LEE DALRYMPLE AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistAMFT121614CA

General Provider Information

NPI Number : 1285395616
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRESTA LEE DALRYMPLE AMFT
Provider Business Mailing Address
First Line : 16827 BIRCHER ST
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-2714
Country : US
Telephone Number : 323-683-4183
Fax Number :
Provider Business Practice Location Address
First Line : 491 S MARENGO AVE OFC 3
Second Line :
City : PASADENA
State : CA
Zip : 91101-3128
Country : US
Telephone Number : 323-683-4183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2022
Last Update Date : 01/07/2022

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