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General NPI Number Information
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NPI Number | 1639531247
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Entity Type | Individual
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Provider Name | KRISTINE LUCIA KING LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 18050 VANOWEN ST
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City | RESEDA
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State | CA
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Zip | 91335-5638
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Country | US
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Telephone | 818-888-4559
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Fax | 818-888-4005
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Provider Business Mailing Address
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Address Line | 19329 PLUMMER ST
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2137
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Country | US
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Telephone | 805-428-5135
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120585
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License Number State | CA
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