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NPI Code Detail

MEDICARE: KRISTIN KITAGAWA

MEDICARE: KRISTIN KITAGAWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist48019CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
148019OTHERCABBS

General Provider Information

NPI Number : 1033641220
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN KITAGAWA
Provider Business Mailing Address
First Line : 1441 N D ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4747
Country : US
Telephone Number : 951-384-0032
Fax Number :
Provider Business Practice Location Address
First Line : 1441 N D ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4747
Country : US
Telephone Number : 951-384-0082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2017
Last Update Date : 07/10/2024

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Directions to “ KRISTIN KITAGAWA ” Practice Location

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