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General NPI Number Information
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NPI Number | 1023517273
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Entity Type | Individual
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Provider Name | KELLY LITTLE LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 100 W FOOTHILL BLVD STE 104
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City | SAN DIMAS
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State | CA
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Zip | 91773-1170
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Country | US
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Telephone | 626-603-8396
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Fax | 626-413-3423
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Provider Business Mailing Address
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Address Line | PO BOX 392
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City | MONROVIA
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State | CA
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Zip | 91017-0392
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Country | US
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Telephone | 626-603-8396
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Fax | 626-413-3423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 101665
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 123673
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License Number State | CA
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