MEDICARE: KRISTEN HUNTLEY MSW, ASW

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
1	1041C0700X	Clinical Social Worker	ASW92861	CA

General Provider Information

NPI Number	:	1386374122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN HUNTLEY MSW, ASW

Provider Business Mailing Address
First Line	:	27235 TRINIDAD CT
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-2148
Country	:	US
Telephone Number	:	661-310-4942
Fax Number	:

Provider Business Practice Location Address
First Line	:	28494 WESTINGHOUSE PL
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91355-0930
Country	:	US
Telephone Number	:	661-259-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	06/14/2022

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