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NPI Code Detail

MEDICARE: KRISTEN KOLZOW LCSW

MEDICARE: KRISTEN KOLZOW LCSW
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
11041C0700XClinical Social WorkerLCS 24524CA

General Provider Information

NPI Number : 1851431498
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN KOLZOW LCSW
Provider Business Mailing Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-993-1106
Provider Business Practice Location Address
First Line : 1907 BOYS REPUBLIC DR
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-5447
Country : US
Telephone Number : 909-628-1217
Fax Number : 909-993-1106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 03/17/2018

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Directions to “ KRISTEN KOLZOW LCSW” Practice Location

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