Healthcare Provider Details

I. General information

NPI: 1780866285
Provider Name (Legal Business Name): KRISTIN KLEPPE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 IRVINE CENTER DR SUITE 800
IRVINE CA
92618-2923
US

IV. Provider business mailing address

7700 IRVINE CENTER DR SUITE 800
IRVINE CA
92618
US

V. Phone/Fax

Practice location:
  • Phone: 949-528-6300
  • Fax: 855-779-3627
Mailing address:
  • Phone: 949-528-6300
  • Fax: 855-779-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number24845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: