Healthcare Provider Details

I. General information

NPI: 1033070917
Provider Name (Legal Business Name): KRISTEN HARTLEY DELFOSSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ELM DR
BEVERLY HILLS CA
90212-4011
US

IV. Provider business mailing address

811 20TH ST
SANTA MONICA CA
90403-2025
US

V. Phone/Fax

Practice location:
  • Phone: 310-229-3665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number210072024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: