Healthcare Provider Details

I. General information

NPI: 1144138728
Provider Name (Legal Business Name): MARISA LYNN KUNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4132 WARNER BLVD APT C
BURBANK CA
91505-4150
US

IV. Provider business mailing address

4132 WARNER BLVD APT C
BURBANK CA
91505-4150
US

V. Phone/Fax

Practice location:
  • Phone: 310-663-5322
  • Fax:
Mailing address:
  • Phone: 310-663-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number156450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: