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General NPI Number Information
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NPI Number | 1285929984
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Entity Type | Individual
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Provider Name | KRISTEN KERRY CROWE
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Gender | Female
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 2904 W SUNSET BLVD STE 6
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City | LOS ANGELES
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State | CA
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Zip | 90026-7308
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Country | US
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Telephone | 213-259-3793
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 OBISPO AVE
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City | LONG BEACH
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State | CA
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Zip | 90804-1724
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Country | US
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Telephone | 714-614-6574
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5451
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | 1267
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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