Healthcare Provider Details

I. General information

NPI: 1235853524
Provider Name (Legal Business Name): JOLIE ROSALILY RITTENBERRY-KRAEMER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-3204
US

IV. Provider business mailing address

2404 WILSHIRE BLVD APT 7D
LOS ANGELES CA
90057-3341
US

V. Phone/Fax

Practice location:
  • Phone: 213-924-3935
  • Fax:
Mailing address:
  • Phone: 213-924-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number144210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: