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General NPI Number Information
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NPI Number | 1255268348
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Entity Type | Organization
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Legal Business Name | DIVINE DESIGN HEALTH
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 3662 REGAL PL
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City | LOS ANGELES
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State | CA
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Zip | 90068-1230
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Country | US
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Telephone | 323-874-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 500 S SEPULVEDA BLVD FL 4
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City | LOS ANGELES
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State | CA
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Zip | 90049-3550
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Country | US
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Telephone | 323-874-2565
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DEBRA KREUTER
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Credential | BSN, RN, CFMP
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Telephone | 323-874-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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