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General NPI Number Information
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NPI Number | 1730341728
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Entity Type | Individual
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Provider Name | KURT L KOZMA LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 514 N CALIFORNIA AVE SUITE 4
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City | BEAUMONT
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State | CA
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Zip | 92223-2113
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Country | US
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Telephone | 909-838-6981
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Fax | 909-614-7421
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Provider Business Mailing Address
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Address Line | 17663 COLONIAL CT
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City | CHINO HILLS
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State | CA
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Zip | 91709-4562
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Country | US
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Telephone | 909-838-6981
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Fax | 909-614-7421
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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 | MFC23650
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License Number State | CA
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