Healthcare Provider Details

I. General information

NPI: 1639630189
Provider Name (Legal Business Name): KRISTEN MCALEENAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N MINNESOTA AVE APT 31
GLENDORA CA
91741-6914
US

IV. Provider business mailing address

200 N MINNESOTA AVE APT 31
GLENDORA CA
91741-6914
US

V. Phone/Fax

Practice location:
  • Phone: 626-808-7197
  • Fax:
Mailing address:
  • Phone: 909-235-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111987
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83234
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: