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General NPI Number Information
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NPI Number | 1881347912
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Entity Type | Individual
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Provider Name | KRISTIN KAY HERBERT AMFT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2022
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 321 N LARCHMONT BLVD STE 622
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City | LOS ANGELES
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State | CA
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Zip | 90004-6406
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Country | US
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Telephone | 424-325-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 S CURSON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-3809
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Country | US
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Telephone | 310-339-8467
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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 | 124146
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License Number State | CA
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