Healthcare Provider Details

I. General information

NPI: 1033984174
Provider Name (Legal Business Name): ANNA KREITER, PSYCHOLOGIST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 OAK AVE
MANHATTAN BEACH CA
90266-2823
US

IV. Provider business mailing address

2308 OAK AVE
MANHATTAN BEACH CA
90266-2823
US

V. Phone/Fax

Practice location:
  • Phone: 415-384-9735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA KREITER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PSYD
Phone: 415-384-9735